SINGLE PORT LAPAROSCOPIC CHOLECYSTECTOMY: TECHNICAL ASPECTS AND RESULTS

ABSTRACT Background: The search for less traumatic surgical procedures without compromising efficacy and safety, together with the technological advances and greater experience of the teams, led to the development of operative techniques with increasingly smaller incisions, the so-called “minimally invasive surgeries”. Aim: To evaluate the technical aspects and results of single port cholecystectomy. Method: Were analyzed 170 patients between 18-74 years submitted to videolaparoscopic cholecystectomies by single port, regardless of elective or urgent indication, without restriction of patient selection. Results: Among the 170 operations, 158 were exclusively performed by single port, and the conversion rate was 7% (inclusion of other accessory trocars or conversion to multiportal). Conversion to open surgery occurred in three cases (1.76%). The mean surgical time was 67.97 min, showing a marked decrease when was reached close to 50 cases and a stabilization after 100 surgeries. The overall complication rate was 10%, with minor complications such as: incisional pain, hematomas, granulomas, port access hernias (9.41%). Conclusion: Single port cholecystectomy can, after standardization and surgical team training, be a safe surgical procedure associated with a recognized aesthetic advantage.

摘要
研究背景：在追求创伤更小且不降低疗效与安全性的外科手术方式的同时，随着技术进步与手术团队经验的积累，切口愈发微小的手术技术应运而生，即所谓的“微创手术（minimally invasive surgeries）”。
研究目的：评估单孔胆囊切除术（single port cholecystectomy）的技术要点与临床疗效。
研究方法：本研究分析了170例年龄介于18~74岁的患者，所有患者均接受单孔腹腔镜胆囊切除术（videolaparoscopic cholecystectomies），手术指征涵盖择期与急诊，未对患者选择施加任何限制。
研究结果：170例手术中，158例仅通过单孔路径完成，中转率为7%（加用其他辅助套管针或转为多孔腹腔镜手术）。另有3例（1.76%）中转至开放手术。平均手术时长为67.97分钟，在完成约50例手术后手术时长显著缩短，并在完成100例手术后趋于稳定。总体并发症发生率为10%，其中轻症并发症包括切口疼痛、血肿、肉芽肿及穿刺孔疝（占比9.41%）。
研究结论：经手术流程标准化与手术团队培训后，单孔胆囊切除术可成为一项安全的外科术式，同时具备公认的美学优势。