Journal of laparoendoscopic & advanced surgical techniques. Part A
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J Laparoendosc Adv Surg Tech A · Aug 2019
Comparative StudySafety and Efficiency of Single-Incision Laparoscopic Cholecystectomy in Obese Patients: A Case-Matched Comparative Analysis.
Background: Single-incision laparoscopic surgery (SILS) is feasible and safe for most situations that indicate a need for cholecystectomy in normal-weight patients. SILS might offer several potential benefits over multiport laparoscopy. However, the effect of obesity on the surgical outcomes of single-incision laparoscopic cholecystectomy (SILC) has not been sufficiently investigated and is controversial. ⋯ In each group, 4 patients needed conversion to multiport laparoscopy or open procedure (1.9% versus 3.8% for non-obese versus obese; P = .236). No significant difference was noted for postoperative complications (4.3% versus 5.7% for non-obese versus obese; P = .790) and the length of hospital stay (3.3 days versus 3.3 days; P = .958). Obese patients have a significantly (P = .027) higher incisional hernia rate (9.8%) than non-obese patients (1.9%), with obesity being a risk factor for hernia development in the univariate analysis. Conclusion: SILC in obese patients is technically feasible and safe compared with non-obese patients in regard to postoperative complications, conversion rates, and length of hospital stay but with an almost sixfold risk of umbilical incisional hernia on the long run.