• Causal effect
• Cholecystitis
• Gastroesophageal reflux disease
• Mendelian randomization
• Single-nucleotide polymorphisms

• Humans
• Mendelian Randomization Analysis
• Gastroesophageal Reflux/genetics
• Gastroesophageal Reflux/complications
• Polymorphism, Single Nucleotide
• Genome-Wide Association Study
• Cholecystitis/genetics
• Genetic Predisposition to Disease
• Risk Factors
• Causality

• Q202242 This work was funded by the Wuxi Health Commission Youth Project.
• HB2023046 Top Talent Support Program for Young and Middle-Aged People of the Wuxi Health Committee
• 82303117 National Natural Science Foundation of China

• general surgery
• minimally invasive surgery
• robotic surgery
• single-incision robotic assisted surgery
• single-incision surgery
• single-site surgery

• Humans
• Robotic Surgical Procedures/methods
• Robotics
• Laparoscopy/methods
• Minimally Invasive Surgical Procedures
• Surgical Wound

• Acute cholecystitis
• Chronic cholecystitis
• Laparo-endoscopic single-site surgery
• Single incision laparoscopic cholecystectomy
• Single incision laparoscopic surgery
• Single-port access surgery

• Cholecystectomy
• Cholecystitis/surgery
• Cholecystitis, Acute/surgery
• Humans
• Postoperative Complications/epidemiology
• Postoperative Complications/surgery
• Reproducibility of Results
• Retrospective Studies

The benefits of laparoscopic surgery (LS) include a speedy recovery, shorter duration of hospital stay, minimal postoperative pain, discomfort and disabilities, and better cosmetic outcomes (less scarring) that help an individual to resume normal daily activities and return to work. A comprehensive literature search on laparoscopic surgeries was conducted using different Internet-based search engines and databases from August 2021 to October 2021. The search was limited to articles published in the English language and those published between years 2005 and 2021. A total of 126 articles were initially identified. Two independent reviewers thoroughly examined the quality and content of the articles. Articles with duplicate data were excluded, and the remaining articles were screened and assessed by the titles and abstracts. After a vigorous assessment, we included data from 49 articles for this review process. Bibliographic management was done using the software “EndNote” (Thomson Reuters, New York, NY, USA).

It was concluded that LS has become the technique of choice for virtually every kind of abdominal surgery, evident by numerous scholarly publications in this field. Level I evidence demonstrating the advantage of LS over open surgery has been reported for numerous operations, including fundoplication for gastroesophageal regurgitation disease, bariatric surgery for weight loss, and cancer resection. Advanced LS has subsequently been expanded to include hepatectomy, pancreatectomy, urology, and gynecology. Patients who are at risk of having elevated abdominal pressure during LS, however, should proceed with care. Recent advances in natural orifice transluminal endoscopic surgery, single-incision laparoscopic surgery, and robot-assisted laparoscopic surgery are promising.

• Cholecystectomy/methods
• Cholecystitis/surgery
• Humans
• Laparoscopy/methods
• Laparoscopy/standards
• Laparotomy/methods
• Minimally Invasive Surgical Procedures/methods
• Network Meta-Analysis
• Randomized Controlled Trials as Topic/methods

There has been no prior report of single-incision laparoscopic surgery (SILS) from the Caribbean island of Turks and Caicos. We report our initial experience with SILS cholecystectomy to show that SILS in this environment is feasible with minimal change to the existing hardware. It is a safe alternative to conventional multi-trocar laparoscopic cholecystectomy in this setting.

• caribbean
• cholecystectomy
• gallbladder
• laparoscopic
• sils
• single incision

• Conventional
• Laparoscopic cholecystectomy
• Meta-analysis
• Single-incision
• Systematic review

• Bile
• Blood Loss, Surgical
• Cholecystectomy, Laparoscopic/adverse effects
• Conversion to Open Surgery
• Female
• Humans
• Incisional Hernia/etiology
• Male
• Middle Aged
• Operative Time
• Outcome Assessment, Health Care
• Pain, Postoperative/etiology
• Publication Bias
• Randomized Controlled Trials as Topic
• Risk
• Surgical Wound
• Surgical Wound Infection/etiology
• Visual Analog Scale

• Cholecystectomy
• Health Care Costs
• Laparoscopic
• Treatment Outcome

• Caribbean
• Laparoscopy
• SILS
• Trinidad

• Conventional
• laparoscopic cholecystectomy
• minimally invasive surgery
• post-operative complication
• single-port

• Adverse events
• Cholecystectomy
• Meta-analysis
• Randomized controlled trials
• Single-incision

• Cholecystectomy, Laparoscopic/methods
• Humans
• Postoperative Complications
• Randomized Controlled Trials as Topic

Single-incision laparoscopic cholecystectomy (SILC) is widely used as a treatment option for gallbladder disease. However, obesity has been considered a relative contraindication to this approach due to more advanced technical difficulties. The aim of this report was to review our experience with SILC to evaluate the impact of body mass index (BMI) on the surgical outcome.

Between May 2009 and February 2013, 237 patients underwent SILC at our institute. Pre- and post-operative data of the 17 obese patients (O-group) (BMI ≥30 kg/m²) and 220 non-obese patients (NO-group) (BMI <29.9 kg/m²) were compared retrospectively. SILC was performed under general anaesthesia, using glove technique. Indications for surgery included benign gallbladder disease, except for emergent surgeries.

Mean age of patients was significantly higher in the NO-group than O-group (58.9 ± 13.5 years vs. 50.8 ± 14.0 years, P = 0.025). SILC was successfully completed in 233 patients (98.3%). Four patients (1.7%) in the NO-group required an additional port, and one patient was converted to an open procedure. The median operative time was 70 ± 25 min in the NO-group and 75.2 ± 18.3 min in the O-group. All complications were minor, except for one case in the NO-group that suffered with leakage of the cystic duct stump, for which endoscopic nasobiliary drainage was need.

Our findings show that obesity, intended as a BMI ≥30 kg/m², does not have an adverse impact on the technical difficulty and post-operative outcomes of SILC. Obesity-related comorbidities did not increase the risks for SILC.

• Bariatric surgery
• obesity
• single-incision laparoscopic cholecystectomy

• opportunity cost
• single incision laparoscopic cholecystetomy
• conventional laparoscopic cholecystetomy
• economic evaluation

• Cholecystectomy, Laparoscopic/economics
• Cholecystectomy, Laparoscopic/methods
• Cholecystectomy, Laparoscopic/statistics & numerical data
• Costs and Cost Analysis/statistics & numerical data
• Humans
• Length of Stay
• Models, Economic
• Natural Orifice Endoscopic Surgery/economics
• Natural Orifice Endoscopic Surgery/statistics & numerical data
• Operative Time
• Umbilicus

Over the past decade, mini-laparoscopic cholecystectomy (MLC) and single-port laparoscopic cholecystectomy (SILC) have been the two main successful mini-invasive surgical interventions for the treatment of cholecystolithiasis since the advent of laparoscopic cholecystectomy (LC). In this study, we conducted a meta-analysis to compare the two treatment alternatives.

We searched PubMed, CNKI and the Cochrane library for trials that compared MLC and SILC. Risk difference (RD) and mean difference (MD) were calculated with a 95% confidence interval (CI).

Four randomized controlled trials (RCTs) and 2 non-randomized comparative studies (nRCSs) involving 2764 patients were identified. A longer operating time (MD -10.49; 95% CI -18.10, −2.88; P = 0.007) and a shorter wound length (MD 3.65; 95% CI 0.51, 6.78; P = 0.02) were found to be associated with SILC compared with MLC. No significant differences were revealed in conversion, hospital stay, pain relief and cosmetic results. Although a lower incidence of complications was observed with MLC (8.2%) compared with SILC (15.9%), but the difference was not statistically significant (RD -0.06; 95% CI -0.12, 0.00; P = 0.07).

MLC has an advantage over SILC in terms of operating time rather than hospital stay, pain relief, cosmetic results. Though conversion and complication rates were higher with SILC, there existed no statistically differences in the two measures between the two procedures. Whether MLC confers any benefits in terms of conversion or complications still warrants further studies.

The online version of this article (doi:10.1186/s12893-017-0287-x) contains supplementary material, which is available to authorized users.

• Cholecystectomy
• Gastrojejunostomy
• Laparoendoscopic single-site access surgery
• Robotic surgical procedures
• Single-port surgery

• Blood Loss, Surgical
• Body Image
• Cholecystectomy, Laparoscopic/methods
• Cholecystectomy, Laparoscopic/psychology
• Esthetics
• Gallbladder Diseases/psychology
• Gallbladder Diseases/surgery
• Humans
• Incisional Hernia/etiology
• Length of Stay
• Operative Time
• Pain, Postoperative/etiology
• Patient Satisfaction
• Postoperative Complications/etiology
• Randomized Controlled Trials as Topic
• Risk Factors
• Treatment Outcome

• Single-incision laparoscopic cholecystectomy
• additional port
• cholecystitis

• Adult
• Aged
• Aged, 80 and over
• C-Reactive Protein/analysis
• Cholecystectomy, Laparoscopic/methods
• Cholecystitis/blood
• Cholecystitis/surgery
• Female
• Humans
• Logistic Models
• Male
• Middle Aged
• Risk Factors

Increasing experience with minimally invasive surgery and the development of new instruments has resulted in a tendency toward reducing the number of abdominal skin incisions. Retrospective and randomized prospective studies could show the feasibility of single-incision surgery without any increased risk to the patient. However, large prospective multicenter observational datasets do not currently exist.

This prospective multicenter observational quality study will provide a relevant dataset reflecting the feasibility and safety of single-incision surgery. This study focuses on external validity, clinical relevance, and the patients’ perspective. Accordingly, the single-incision multiport/single port laparoscopic abdominal surgery (SILAP) study will supplement the existing evidence, which does not currently allow evidence-based surgical decision making.

The SILAP study is an international prospective multicenter observational quality study. Mortality, morbidity, complications during surgery, complications postoperatively, patient characteristics, and technical aspects will be monitored. We expect more than 100 surgical centers to participate with 5000 patients with abdominal single-incision surgery during the study period.

Funding was obtained in 2012. Enrollment began on January 01, 2013, and will be completed on December 31, 2018. As of January 2016, 2119 patients have been included, 106 German centers are registered, and 27 centers are very active (>5 patients per year).

This prospective multicenter observational quality study will provide a relevant dataset reflecting the feasibility and safety of single-incision surgery. An international enlargement and recruitment of centers outside of Germany is meaningful.

German Clinical Trials Register: DRKS00004594; https://drks-neu.uniklinik-freiburg.de/drks_web/navigate.do?navigationId=trial.HTML&TRIAL_ID=DRKS00004594 (Archived by WebCite at http://www.webcitation.org/6jK6ZVyUs)

• minimally invasive
• quality study
• single-incision

• Long-term review
• Single-incision laparoscopic cholecystectomy (SILC)
• Traditional devices

• Adult
• Cholecystectomy, Laparoscopic/methods
• Cholelithiasis/surgery
• Female
• Follow-Up Studies
• Humans
• Male
• Middle Aged
• Patient Satisfaction
• Polyps/surgery
• Postoperative Complications
• Quality of Life
• Retrospective Studies

• Lung wedge resection
• Thoracoscopy
• Transumbilical

• Cholecystectomy
• incision laparoscopic cholecystectomy
• laparoscopic
• mini-laparoscopic cholecystectomy (MLC)
• operation time
• single-incision laparoscopic cholecystectomy (SILC)

• Laparoendoscopic single-site surgery
• Laparoscopic cholecystectomy
• Laparoscopic common bile duct exploration
• Laparoscopic hepaticojejunostomy
• Single-incision laparoscopic surgery

• Biliary Tract Diseases/diagnosis
• Biliary Tract Diseases/economics
• Biliary Tract Diseases/surgery
• Biliary Tract Surgical Procedures/adverse effects
• Biliary Tract Surgical Procedures/economics
• Biliary Tract Surgical Procedures/methods
• Cholecystectomy, Laparoscopic
• Clinical Competence
• Cost-Benefit Analysis
• Health Care Costs
• Humans
• Laparoscopy/adverse effects
• Laparoscopy/economics
• Learning Curve
• Postoperative Complications/etiology
• Risk Factors
• Treatment Outcome

The greatest advantages of laparoscopy when compared to open surgery include the faster recovery times, shorter hospital stays, decreased postoperative pain, earlier return to work and resumption of normal daily activity as well as cosmetic benefits. Laparoscopy today is considered the gold standard of care in the treatment of cholecystitis and appendicitis worldwide. Laparoscopy has even been adopted in colorectal surgery with good results. The technological improvements in this surgical field along with the development of modern techniques and the acquisition of specific laparoscopic skills have allowed for its utilization in operations with fully intracorporeal anastomoses. Further progress in laparoscopy has included single-incision laparoscopic surgery and natural orifice trans-luminal endoscopic surgery. Nevertheless, laparoscopy for emergency surgery is still considered challenging and is usually not recommended due to the lack of adequate experience in this area. The technical difficulties of operating in the presence of diffuse peritonitis or large purulent collections and diffuse adhesions are also given as reasons. However, the potential advantages of laparoscopy, both in terms of diagnosis and therapy, are clear. Major advantages may be observed in cases with diffuse peritonitis secondary to perforated peptic ulcers, for example, where laparoscopy allows the confirmation of the diagnosis, the identification of the position of the ulcer and a laparoscopic repair with effective peritoneal washout. Laparoscopy has also revolutionized the approach to complicated diverticulitis even when intestinal perforation is present. Many other emergency conditions can be effectively managed laparoscopically, including trauma in select hemodynamically-stable patients. We have therefore reviewed the most recent scientific literature on advances in laparoscopy for acute care surgery and trauma in order to demonstrate the current indications and outcomes associated with a laparoscopic approach to the treatment of the most common emergency surgical conditions.

• Laparoscopy
• Acute care surgery
• Single-incision laparoscopic surgery
• Natural orifice trans-luminal endoscopic surgery
• Trauma

• Abdominal Injuries/diagnosis
• Abdominal Injuries/surgery
• Acute Disease
• Adolescent
• Adult
• Aged, 80 and over
• Clinical Competence
• Diffusion of Innovation
• Digestive System Diseases/diagnosis
• Digestive System Diseases/surgery
• Emergencies
• Female
• Humans
• Laparoscopy/adverse effects
• Learning Curve
• Male
• Postoperative Complications/etiology
• Risk Factors
• Treatment Outcome

Our study aims to evaluate the post-operative pain and cosmesis of single-incision laparoscopic cholecystectomy (SILC) in comparison with the standard, 3-port laparoscopic cholecystectomy (SLC) with respect to the length of incision, cosmetic scores, post-operative pain scores and duration of hospital stay.

This comparative randomised study was conducted in a tertiary care centre teaching hospital between September 2012 and 2014. One hundred and fifty consecutive patients, who qualified as per inclusion criteria, were included in the study.

Seventy-five patients were included in the SLC arm and 75 in the SILC arm. SILC procedure was carried out as transumbilical multiport technique and SLC as 3-port technique utilizing - 5, 5, 10 mm ports.

The data for the primary observations (post-operative pain scores, cosmetic score and incision length) and secondary observation (post-operative hospital stay) were noted. Weighted mean difference was used for calculation of quantitative variables, and odds ratios were used for pooling qualitative variables.

Pain scores at 4 and 24 h were significantly better for SILC arm than SLC arm (at 4 h - 4.84 ± 0.95 vs. 6.17 ± 0.98, P < 0.05 and at 24 h - 3.84 ± 0.96 vs. 5.17 ± 0.09, P < 0.05). Length of incision was significantly smaller (SILC - 2.631 ± 0.44 cm vs. SLC - 5.11 ± 0.44 cm), P < 0.05 and cosmetic score was significantly better in SILC arm (6.25 ± 1.24) than SLC arm (4.71 ± 1.04), P < 0.05. Difference between the hospital stay is insignificant for two arms SILC (2.12 ± 0.34) and SLC (2.13 ± 0.35), P > 0.05.

Significant difference was found in duration and intensity of pain between two procedures at 4 and 24 h. Cosmesis was significantly better in SILC than SLC group, the sample size in our study was small to arrive at a definite conclusion. The procedure can be selectively and judiciously performed by surgeons trained in regular laparoscopic surgery. Furthermore, the threshold for conversion should be low in learning phase. Widespread application must await Level 1 evidence from prospective trials.

• Choledocholithiasis
• Choledochotomy
• Common bile duct exploration
• Laparoscopy
• Single-incision laparoscopic surgery

• Adult
• Aged
• Biliary Tract Surgical Procedures/adverse effects
• Biliary Tract Surgical Procedures/instrumentation
• Common Bile Duct/surgery
• Endoscopes
• Equipment Design
• Feasibility Studies
• Female
• Gallstones/diagnosis
• Gallstones/surgery
• Humans
• Laparoscopy/adverse effects
• Laparoscopy/instrumentation
• Male
• Middle Aged
• Postoperative Complications/etiology
• Retrospective Studies
• Therapeutic Irrigation
• Treatment Outcome

Randomised controlled trials are widely acknowledged as the gold standard in medical research although their validity can be undermined by non-compliance with the randomly allocated treatment and missing data. Due to the nature of the intervention, surgical trials face particular threat to compliance and data collection. For example, ineligibility for the intervention may only become apparent once the operation has commenced. It is unclear how such cases are reported and handled.

The objective was to assess non-compliance and missing data in reports of trials of surgical interventions.

Searches for reports of trials involving at least one surgical procedure and published in 2010 were carried out in the Medical Literature Analysis and Retrieval System Online (MEDLINE^®). Data on missing data, non-compliance and methods of handling missing data were extracted from full texts. Descriptive data analyses were carried out on the data.

Forty-five (55 %) studies reported non-compliance with treatment allocation and 52 (63 %) reported primary outcome missing data. The median levels of non-compliance and missing data were 2 % [IQR (0, 5), range (0–29)] and 6 % [IQR (0, 15), range (0–57)], respectively. Fifty-two (63 %) studies analysed as randomised, 17 (21 %) analysed per protocol and 3 (4 %) analysed as treated. Complete case analysis was the most common method used to deal with missing data, 35/52 (67 %).

The reporting of non-compliance to allocation and the handling of missing data were typically suboptimal. There is still room for improvement on the use of the CONSORT statement particularly in accounting for study participants. Transparency in reporting would facilitate evidence synthesis.

The online version of this article (doi:10.1186/s13104-015-1364-9) contains supplementary material, which is available to authorized users.

• Cholecystectomy/methods
• Cholecystectomy, Laparoscopic
• Cholecystitis, Acute/classification
• Cholecystitis, Acute/diagnosis
• Cholecystitis, Acute/surgery
• Drainage/methods
• Endoscopy, Digestive System
• Gallbladder Diseases/diagnosis
• Gallbladder Diseases/surgery
• Gallbladder Diseases/therapy
• Humans
• Severity of Illness Index

AIM: To compare the characteristics of two single-incision methods, and conventional laparoscopy in cholecystectomy, and demonstrate the safety and feasibility.

METHODS: Three hundred patients with gallstones or gallbladder polyps were admitted to two clinical centers from January 2013 to January 2014 and were randomized into three groups of 100: single-incision three-device group, X-Cone group, and conventional group. The operative time, intraoperative blood loss, complications, postoperative pain, cosmetic score, length of hospitalization, and hospital costs were compared, with a follow-up duration of 1 mo.

RESULTS: A total of 142 males (47%) and 158 females (53%) were enrolled in this study. The population characteristics of these three groups is no significant differences exist in terms of age, sex, body mass index and American Society of Anesthesiology (P > 0.05). In results, there were no significant differences in blood loss, length of hospitalization, postoperative complications.The operative time in X-Cone group was significantly longer than other groups.There were significant differences in postoperative pain scores and cosmetic scores at diffent times after surgery (P < 0.05).

CONCLUSION: This study shows that this two single-incision methods are safe and feasible. Both methods are superior to the conventional procedure in cosmetic and pain scores.

• Cholecystectomy
• Laparoscopic surgery
• Single-incision laparoscopic cholecystectomy

• Cholecystectomy
• Cholecystitis
• Laparoscopic surgery
• Minimal invasive surgery

• Adolescent
• Adult
• Aged
• Appendectomy/methods
• Appendicitis/surgery
• Body Image
• Cholecystectomy, Laparoscopic/methods
• Esthetics
• Feasibility Studies
• Female
• Follow-Up Studies
• Humans
• Intention to Treat Analysis
• Laparoscopy/methods
• Male
• Middle Aged
• Pain, Postoperative
• Treatment Outcome
• Young Adult

• G1002292 Medical Research Council
• HSRU1 Chief Scientist Office
• G0601938 Medical Research Council
• CZG/2/498 Chief Scientist Office