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Fewer-than-four ports versus four ports for laparoscopic cholecystectomy

  1. Kurinchi Selvan Gurusamy1,*,
  2. Jessica Vaughan1,
  3. Michele Rossi2,
  4. Brian R Davidson1

Editorial Group: Cochrane Hepato-Biliary Group

Published Online: 20 FEB 2014

Assessed as up-to-date: 4 SEP 2013

DOI: 10.1002/14651858.CD007109.pub2


How to Cite

Gurusamy KS, Vaughan J, Rossi M, Davidson BR. Fewer-than-four ports versus four ports for laparoscopic cholecystectomy. Cochrane Database of Systematic Reviews 2014, Issue 2. Art. No.: CD007109. DOI: 10.1002/14651858.CD007109.pub2.

Author Information

  1. 1

    Royal Free Campus, UCL Medical School, Department of Surgery, London, UK

  2. 2

    Azienda Ospedaliero-Universitaria Careggi, Endoscopia Chirurgica, Firenze, Firenze, Italy

*Kurinchi Selvan Gurusamy, Department of Surgery, Royal Free Campus, UCL Medical School, Royal Free Hospital, Rowland Hill Street, London, NW3 2PF, UK. k.gurusamy@ucl.ac.uk.

Publication History

  1. Publication Status: New
  2. Published Online: 20 FEB 2014

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References

References to studies included in this review

  1. References to studies included in this review
  2. References to studies excluded from this review
  3. References to ongoing studies
  4. Additional references
Abd Ellatif 2013 {published data only}
  • Abd Ellatif ME, Askar WA, Abbas AE, Noaman N, Negm A, El-Morsy G, et al. Quality-of-life measures after single-access versus conventional laparoscopic cholecystectomy: a prospective randomized study. Surgical Endoscopy 2013;27(6):1896-906.
Bucher 2011 {published data only}
Cerci 2007 {published data only}
Herrero 2012 {published data only}
  • Herrero E, Cugat E, García-Domingo MI, Camps J, Porta R, Carvajal F, et al. A randomised prospective comparative study between laparoscopic cholecystectomy and single port cholecystectomy in a major outpatient surgery unit. Cirugia Espanola 2012;90(10):641-6.
Kumar 2007 {published data only}
  • Kumar M, Agrawal CS, Gupta RK. Three-port versus standard four-port laparoscopic cholecystectomy: A randomized controlled clinical trial in a community-based teaching hospital in eastern Nepal. Journal of the Society of Laparoendoscopic Surgeons 2007;11(3):358-62.
Lirici 2011 {published data only}
  • Lirici MM, Califano AD, Angelini P, Corcione F. Laparo-endoscopic single site cholecystectomy versus standard laparoscopic cholecystectomy: results of a pilot randomized trial. American Journal of Surgery 2011;202(1):45-52.
Luna 2013 {published data only}
  • Luna RA, Nogueira DB, Varela PS, De ORNE, Norton MJR, Do Carmo BRL, et al. A prospective, randomized comparison of pain, inflammatory response, and short-term outcomes between single port and laparoscopic cholecystectomy. Surgical Endoscopy 2013;27(4):1254-9.
Saad 2013 {published data only}
  • Saad S, Strassel V, Martin C, Sauerland S. Single port-versus mini-versus conventional laparoscopic cholecystectomy-a blinded randomized controlled trial. Surgical Endoscopy 2013;27(Suppl 1):S14.
  • Saad S, Strassel V, Sauerland S. Randomized clinical trial of single-port, minilaparoscopic and conventional laparoscopic cholecystectomy. British Journal of Surgery 2013;100(3):339-49.
Sinan 2012 {published data only}
  • Sinan H, Demirbas S, Ozer MT, Sucullu I, Akyol M. Single-incision laparoscopic cholecystectomy versus laparoscopic cholecystectomy: a prospective randomized study. Surgical Laparoscopy, Endoscopy and Percutaneous Techniques 2012;22(1):12-6.

References to studies excluded from this review

  1. References to studies included in this review
  2. References to studies excluded from this review
  3. References to ongoing studies
  4. Additional references
Allemann 2012 {published data only}
  • Allemann P. Safety and cost-effectiveness study of single port laparoscopic cholecystectomies (SPoCOT), 2012. clinicaltrials.gov/show/NCT00974194 (accessed 13 February 2014).
Asakuma 2011 {published data only}
  • Asakuma M. Randomized controlled trial to evaluate the superiority of the Single Port Cholecystectomy (SPC) on reduction of postoperative pain, compared with the conventional laparoscopic cholecystectomy at the single institution, 2011. www.umin.ac.jp/ctr/index.htm (accessed 13 February 2014).
Bansal 2012 {published data only}
  • Bansal VK. A prospective randomized control trial comparing the outcome of the two modalities of treatment of gall stone disease viz. single incision laparoscopic cholecystectomy with standard 4 port laparoscopic cholecystectomy, 2012. www.ctri.nic.in/Clinicaltrials/pmaindet2.php?trialid=5253 (accessed 13 February 2014).
Barugola 2011 {published data only}
  • Barugola G. Single port laparoscopic cholecystectomy versus four port laparoscopic cholecystectomy: impact on postoperative pain, 2011. clinicaltrials.gov/show/NCT01348620 (accessed 13 February 2014).
Bingener-Casey 2012 {published data only}
  • Bingener-Casey J. Comparative effectiveness of novel minimally invasive procedures, 2012. clinicaltrials.gov/show/NCT01489436 (accessed 13 February 2014).
Bresadola 1999 {published data only}
Broeders 2010 {published data only}
Brown 2013 {published data only}
  • Brown KM, Moore BT, Sorensen GB, Boettger CH, Tang F, Jones PG, et al. Patient-reported outcomes after single-incision versus traditional laparoscopic cholecystectomy: a randomized prospective trial. Surgical Endoscopy 2013;27(9):3108-15.
Cao 2011 {published data only}
  • Cao ZG, Cai W, Qin MF, Zhao HZ, Yue P, Li Y. Randomized clinical trial of single-incision versus conventional laparoscopic cholecystectomy: short-term operative outcomes. Surgical Laparoscopy, Endoscopy and Percutaneous Techniques 2011;21(5):311-3.
Chang 2013 {published data only}
  • Chang SK, Wang YL, Shen L, Iyer SG, Shaik AB, Lomanto D. Interim report: A randomized controlled trial comparing postoperative pain in single-incision laparoscopic cholecystectomy and conventional laparoscopic cholecystectomy. Asian Journal of Endoscopic Surgery 2013;6(1):14-20.
Chen 2002 {published data only}
  • Chen TW, Hsieh CB, Huang SH, Yu JC, Liu YC, Monduzzi Editore MEME. Learning curves of an inexperienced surgeon for three-port microlaparoscopic cholecystectomy and four-port laparoscopic cholecystectomy. XXXIII World Congress of the International College of Surgeons - ICS 2002. 2002:99-103.
Cockbain 2013 {published data only}
Dam 2011 {published data only}
  • Dam DAV. Single Incision, MiniPort or convEntional Laparoscopic surgery for uncomplicated sympthomatic cholecystolithiasis (SIMPEL-trial), 2011. www.trialregister.nl/trialreg/admin/rctview.asp?TC=3100 (accessed 13 February 2014).
de Carvalho 2013 {published data only}
  • de Carvalho LFA, Fierens K, Kint M. Mini-laparoscopic versus conventional laparoscopic cholecystectomy: a randomized controlled trial. Journal of Laparoendoscopic & Advanced Surgical Techniques 2013;23(2):109-16.
Garg 2012 {published data only}
  • Garg P, Thakur JD, Singh I, Nain N, Mittal G, Gupta V. A prospective controlled trial comparing single-incision and conventional laparoscopic cholecystectomy: caution before damage control. Surgical Laparoscopy, Endoscopy and Percutaneous Techniques 2012;22(3):220-5.
Gupta 2005 {published data only}
  • Gupta A, Shrivastava UK, Kumar P, Burman D. Minilaparoscopic versus laparoscopic cholecystectomy: a randomised controlled trial. Tropical Gastroenterology 2005;26(3):149-51.
Hansen 2011 {published data only}
  • Hansen P. A randomized trial of single port laparoscopic cholecystectomy versus four port laparoscopic cholecystectomy, 2011. clinicaltrials.gov/show/NCT00892879 (accessed 13 February 2014).
Hauters 2013 {published data only}
  • Hauters P, Auvray S, Cardin JL, Papillon M, Delaby J, Dabrowski A, et al. Comparison between single-incision and conventional laparoscopic cholecystectomy: a prospective trial of the Club Coelio. Surgical Endoscopy 2013;27(5):1689-94.
Hu 2005 {published data only}
  • Hu H. Clinical application and study on three-port-looping laparoscopic cholecystectomy. China Journal of Endoscopy 2005;11:552.
Hu 2010 {published data only}
Jorgensen 2010 {published data only}
  • Jorgensen LN. Efficacy of transumbilical versus standard laparoscopic cholecystectomy on postoperative pain, 2010. clinicaltrials.gov/show/NCT01268748 (accessed 13 February 2014).
Khorgami 2011 {published data only}
  • Khorgami Z. Comparison of perioperative outcomes following four port, three port and single incision laparoscopic cholecystectomy in patients of Shariati hospital in 2011. www.irct.ir/searchresult.php?id=2982&number=4 (accessed 13 February 2014).
Kim 2009 {published data only}
  • Kim SS, Kim SH, Mun SP. Should subcostal and lateral trocars be used in laparoscopic cholecystectomy? A randomized, prospective study. Journal of Laparoendoscopic and Advanced Surgical Techniques. Part A 2009;19(6):749-53.
Lai 2011 {published data only}
  • Lai EC, Yang GP, Tang CN, Yih PC, Chan OC, Li MK. Prospective randomized comparative study of single incision laparoscopic cholecystectomy versus conventional four-port laparoscopic cholecystectomy. American Journal of Surgery 2011;202(3):254-8.
Lee 2010 {published data only}
Leung 2011 {published data only}
  • Leung D, Denham W, Salabat M, Butt Z, Barrera E, Ujiki M. Single-incision laparoscopic cholecystectomy results in similar short-term post-operative pain and quality of life scores when compared to multi-incision: A prospective randomized blinded comparison. Surgical Endoscopy and Other Interventional Techniques 2011;25(1 Suppl):S239.
Limberger 2005 {published data only}
  • Limberger A, Pluszcyk T, Schilling M. [Laparoscopic cholecystectomy. Preliminary results of a comparison of 2 and 3 trocar operation techniques]. Chirurgische Praxis 2005;64(1):35-40.
Ma 2011 {published data only}
  • Ma J, Cassera MA, Spaun GO, Hammill CW, Hansen PD, Aliabadi-Wahle S. Randomized controlled trial comparing single-port laparoscopic cholecystectomy and four-port laparoscopic cholecystectomy. Annals of Surgery 2011;254(1):22-7.
Madureira 2013 {published data only}
  • Madureira FA, Manso JE, Madureira Filho D, Iglesias AC. Inflammation in laparoendoscopic single-site surgery versus laparoscopic cholecystectomy. Surgical Innovation 2013; Vol. Epub ahead of print.
  • Madureira FAV, Manso JEF, Fo DM, Iglesias ACG. Randomized clinical study for assessment of incision characteristics and pain associated with LESS versus laparoscopic cholecystectomy. Surgical Endoscopy 2013;27(3):1009-15.
  • Madureira FAV, Manso JEF, Madureira D, Iglesias ACG. Inflammation in less versus laparoscopic cholecystectomy. Surgical Endoscopy 2013;27:S444.
Marks 2011 {published data only}
  • Marks J, Tacchino R, Roberts K, Onders R, Denoto G, Paraskeva P, et al. Prospective randomized controlled trial of traditional laparoscopic cholecystectomy versus single-incision laparoscopic cholecystectomy: report of preliminary data. American Journal of Surgery 2011;201(3):369-72.
Marks 2012 {published data only}
  • Marks J. Prospective randomized controlled trial of traditional laparoscopic cholecystectomy versus SILS™ port laparoscopic cholecystectomy, 2012. clinicaltrials.gov/show/NCT00832767 (accessed 13 February 2014).
Marks 2013 {published data only}
  • Marks JM, Phillips MS, Tacchino R, Roberts K, Onders R, DeNoto G, et al. Single-incision laparoscopic cholecystectomy is associated with improved cosmesis scoring at the cost of significantly higher hernia rates: 1-year results of a prospective randomized, multicenter, single-blinded trial of traditional multiport laparoscopic cholecystectomy vs single-incision laparoscopic cholecystectomy. Journal of the American College of Surgeons 2013;216(6):1037-47.
McGregor 2011 {published data only}
  • McGregor CG, Sodergren MH, Aslanyan A, Wright VJ, Purkayastha S, Darzi A, et al. Evaluating systemic stress response in single port vs. multi-port laparoscopic cholecystectomy. Journal of Gastrointestinal Surgery 2011;15(4):614-22.
Moran 2011 {published data only}
  • Moran M, Gundogdu E, Dizen H, Akgun AE, Ozmen MM. Single vs two vs three vs four incision laparoscopic cholecystectomy: a randomized controlled clinical trial. Surgical Endoscopy and Other Interventional Techniques 2011;25(1 Suppl):S34.
Mosca 2012 {published data only}
  • Mosca F, Cuschieri A. EndoCone single port versus conventional multi-port laparoscopic approach, 2012. clinicaltrials.gov/show/NCT01709877 (accessed 13 February 2014).
Ng 1999 {published data only}
Noguera 2012 {published data only}
  • Noguera JF, Cuadrado A, Dolz C, Olea JM, Garcia JC. Prospective randomized clinical trial comparing laparoscopic cholecystectomy and hybrid Natural Orifice Transluminal Endoscopic Surgery (NOTES) (NCT00835250). Surgical Endoscopy 2012;26(12):3435-41.
Ospanov 2013 {published data only}
  • Ospanov OB, Khassenov RE. Length of the wound and postoperative scar after using single port laparoscopic cholecystectomy. Surgical Endoscopy 2013;27(Suppl 1):S74.
Ostlie 2013 {published data only}
  • Ostlie DJ, Adibe David Juang OO, Iqbal CW, Sharp SW, Snyder CL, Andrews WS, et al. Single incision versus standard 4-port laparoscopic cholecystectomy: a prospective randomized trial. Journal of Pediatric Surgery 2013;48(1):209-14.
  • Ostlie DJ, Sharp NE, Thomas P, Sharp SW, Holcomb GW, Peter SD. Patient scar assessment after single-incision versus four-port laparoscopic cholecystectomy: long-term follow-up from a prospective randomized trial. Journal of Laparoendoscopic and Advanced Surgical Techniques. Part A 2013;23(6):553-5.
Pappas-Gogos 2010 {published data only}
  • Pappas-Gogos G. Study of oxidative stress in standard laparoscopic vs single port cholecystectomy for uncomplicated cholelithiasis (LAP vs SILS), 2010. clinicaltrials.gov/show/NCT01211743 (accessed 13 February 2014).
Pathania 2013 {published data only}
  • Pathania BS. A comparative clinical evaluation of single incision laparoscopic cholecystectomy with single and multiport access versus conventional mufti -port laparoscopic cholecystectomy. European Surgical Research 2013;50:13-4.
Patricia 2010 {published data only}
  • Patricia YCL. Prospective randomized trial of single port laparoscopic cholecystectomy versus four ports laparoscopic cholecystectomy in patients with gallbladder stones, 2010. www.anzctr.org.au/Trial/Registration/TrialReview.aspx?ACTRN=12610000006044 (accessed 13 February 2014).
Phillips 2012 {published data only}
  • Phillips MS, Marks JM, Roberts K, Tacchino R, Onders R, DeNoto G, et al. Intermediate results of a prospective randomized controlled trial of traditional four-port laparoscopic cholecystectomy versus single-incision laparoscopic cholecystectomy. Surgical Endoscopy 2012;26(5):1296-303.
  • Phillips MS, Marks JM, Tacchino R, Roberts K, Onders R, De Noto G, et al. Prospective randomized controlled trial of traditional four port laparoscopic cholecystectomy versus single incision laparoscopic cholecystectomy. Surgical Endoscopy 2011;25:S217.
Poon 2003 {published data only}
Sasaki 2012 {published data only}
  • Sasaki A, Ogawa M, Tono C, Obara S, Hosoi N, Wakabayashi G. Single-port versus multiport laparoscopic cholecystectomy: a prospective randomized clinical trial. Surgical Laparoscopy, Endoscopy and Percutaneous Techniques 2012;22(5):396-9.
Soroush 2011 {published data only}
  • Soroush M. The comparison between result of single port laparoscopic cholecystectomy with 4 ports cholecystectomy, 2011. www.irct.ir/searchresult.php?id=6359&number=1 (accessed 13 February 2014).
Steinemann 2011 {published data only}
  • Steinemann DC, Raptis DA, Lurje G, Oberkofler CE, Wyss R, Zehnder A, et al. Cosmesis and body image after single-port laparoscopic or conventional laparoscopic cholecystectomy: a multicenter double blinded randomised controlled trial (SPOCC-trial). BMC Surgery 2011;11:24.
Tacchino 2011 {published data only}
  • Tacchino R, Marks J, Onders R, DeNoto G, Paraskeva B, Rivas H, et al. Conventional 4-port laparoscopic cholecystectomy versus SILS port laparoscopic cholecystectomy. The first prospective randomized sham controlled trial. Surgical Endoscopy and Other Interventional Techniques 2011;25(1 Suppl):S35.
Trichak 2003 {published data only}
Tsimogiannis 2010 {published data only}
  • Tsimogiannis K. Study of the inflammatory reaction in standard vs single port cholecystectomy for uncomplicated cholelithiasis, 2010. clinicaltrials.gov/show/NCT01116492 (accessed 13 February 2014).
Tsimoyiannis 2010 {published data only}
  • Tsimoyiannis EC, Tsimogiannis KE, Pappas-Gogos G, Farantos C, Benetatos N, Mavridou P, et al. Different pain scores in single transumbilical incision laparoscopic cholecystectomy versus classic laparoscopic cholecystectomy: a randomized controlled trial. Surgical Endoscopy 2010;24(8):1842-8.
Umit Ugurlu 2013 {published data only}
  • Umit Ugurlu M, Tahir Oruc M. Comparison of single-incision laparoscopic cholecystectomy with standard laparoscopic approach. Surgical Endoscopy 2013;27(Suppl S1):S457.
Vezakis 2010 {published data only}
  • Vezakis A, Polymeneas G. A randomised comparison between single incision laparoscopic cholecystectomy and standard laparoscopic cholecystectomy, 2010. clinicaltrials.gov/show/NCT01094379 (accessed 13 February 2014).
Vilallonga 2012 {published data only}
  • Vilallonga R, Barbaros U, Sumer A, Demirel T, Fort J, Gonzalez O, et al. Single-port transumbilical laparoscopic cholecystectomy: a prospective randomised comparison of clinical results of 140 cases. Journal of Minimal Access Surgery 2012;8(3):74-8.

References to ongoing studies

  1. References to studies included in this review
  2. References to studies excluded from this review
  3. References to ongoing studies
  4. Additional references
Mosca 2013 {published data only}
  • Mosca F. EndoCone single port versus conventional multi-port laparoscopic approach, 2013. clinicaltrials.gov/show/NCT01709877 (accessed 13 February 2014).
Soroush 2013 {published data only}
  • Soroush M. The comparison between result of single port laparoscopic cholecystectomy with 4 ports cholecystectomy, 2013. www.irct.ir/searchresult.php?id=6359&number=1 (accessed 13 February 2014).
Takada 2013 {published data only}
  • Takada Y. Randomized study comparing quality of life after single-port versus conventional 4-port laparoscopic cholecystectomy, 2013. www.umin.ac.jp/ctr/index.htm (accessed 13 February 2014).

Additional references

  1. References to studies included in this review
  2. References to studies excluded from this review
  3. References to ongoing studies
  4. Additional references
Alponat 2002
  • Alponat A, Cubukcu A, Gonullu N, Canturk Z, Ozbay O. Is minisite cholecystectomy less traumatic? Prospective randomized study comparing minisite and conventional laparoscopic cholecystectomies. World Journal of Surgery 2002;26(12):1437-40.
Bakken 2004
  • Bakken IJ, Skjeldestad FE, Mjåland O, Johnson E. Cholecystectomy in Norway 1990-2002 [Kolecystektomi i Norge i 1990-2002]. Tidsskrift for den Norske Laegeforening 2004;124(18):2376-8.
Bisgaard 2002
  • Bisgaard T, Klarskov B, Trap R, Kehlet H, Rosenberg J. Microlaparoscopic vs conventional laparoscopic cholecystectomy: a prospective randomized double-blind trial. Surgical Endoscopy 2002;16(3):458-64.
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