Single‑incision laparoscopic cholecystectomy

3.1 Single‑incision laparoscopic cholecystectomy aims to remove the gallbladder through a single incision, which is usually made near the umbilicus. The claimed benefits of this procedure over standard laparoscopic cholecystectomy include less pain, shorter recovery time, fewer wound complications and improved cosmesis.

3.2 Single‑incision laparoscopic cholecystectomy is done with the patient under general anaesthesia. There are 2 surgical approaches. One uses a single umbilical skin incision with skin flaps to insert ports through multiple fascial punctures. The other uses a specifically designed device that allows multiple instruments to be passed through a single port placed in or near the umbilicus. A pneumoperitoneum is established and the gallbladder is retracted with a laparoscopic instrument ('grasper') or by a transabdominal suture. The hilum of the gallbladder is dissected using endoscopic instruments. The cystic artery and cystic duct are clipped and divided and the gallbladder is separated from the liver. At least 1 additional port in the epigastrium may be needed if a cholangiogram is performed or if the common bile duct is explored. The gallbladder is removed through the umbilical incision.