World Journal of Laparoscopic Surgery

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VOLUME 7 , ISSUE 2 ( May-August, 2014 ) > List of Articles

RESEARCH ARTICLE

Pain and Cosmesis following Four-Port Laparoscopic Cholecystectomy: The Patient View

AR Dennison, M Patel, CP Neal, MS Metcalfe, G Garcea

Citation Information : Dennison A, Patel M, Neal C, Metcalfe M, Garcea G. Pain and Cosmesis following Four-Port Laparoscopic Cholecystectomy: The Patient View. World J Lap Surg 2014; 7 (2):66-68.

DOI: 10.5005/jp-journals-10033-1219

Published Online: 01-08-2014

Copyright Statement:  Copyright © 2014; Jaypee Brothers Medical Publishers (P) Ltd.


Abstract

Introduction

The standard four-port laparoscopic cholecystectomy (SLC) is presently the gold standard in gallbladder surgery in the United Kingdom. The introduction of single port laparoscopic cholecystectomy (SILC) is said to offer potential improvements in pain and cosmesis postoperatively. This study surveyed patient satisfaction at each of their port sites following uncomplicated four-port cholecystectomy.

Materials and methods

Retrospective postal questionnaire poll of 100 patients aged between 18 and 82. A ten-point visual analog score was used to assess postoperative pain at each respective port site within the first 72 hours. A similar scale was used to assess cosmetic satisfaction relating to scar color, stiffness, thickness and irregularity. Patients were asked whether or not they would prefer a single incision operation based on their experience of the standard four-port technique.

Results

Sixty-one patients returned their questionnaires (61% response rate). The median pain scores were highest at the umbilical port site the epigastric port site collectively had the worst cosmetic outcome in terms of satisfaction with scar color, stiffness, thickness and irregularity. 79.7% of patients were satisfied with the four-port procedure and only 20.3% would have preferred a single-port operation if given the option.

Conclusion

Patient satisfaction with standard four-port cholecystectomy is high. The umbilical port was consistently the most painful postoperatively, with cosmesis scores being worst for the epigastric port site. However, there is no firm data that would support SILC over SLC based on this evidence.

How to cite this article

Patel M, Neal CP, Dennison AR, Metcalfe MS, Garcea G. Pain and Cosmesis following Four-Port Laparoscopic Cholecystectomy: The Patient View. World J Lap Surg 2014;7(2):66-68.


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  1. nhs.uk/pages/homepage.aspx.Date last accessed on 13/10/2012.
  2. Onewound laparoscopic cholecystectomy. Br J Surg 1997;84(5):695.
  3. Prospective randomized controlled trial of traditional laparoscopic cholecystectomy versus single-incision laparoscopic cholecystectomy: report of preliminary data. Am J Surg 2011;201(3):369-372.
  4. Postoperative pain after cholecystectomy: conventional laparoscopy versus single-incision laparoscopic surgery. J Minim Access Surg 2011;7(1):24-27.
  5. Single-incision surgery has higher cost with equivalent pain and quality-of-life scores compared with multiple-incision laparoscopic cholecystectomy: a prospective randomized blinded comparison. J Am Coll Surg 2012 Nov;215(5):702-708.
  6. Single-incision laparoscopic cholecystectomy: a systematic review. Arch Surg 2012 Jul 1;147(7):657-666.
  7. Single-incision laparoscopic cholecystectomy vs conventional laparoscopic cholecystectomy: a meta-analysis of randomized controlled trials. J Gastrointest Surg 2012 Aug;16(8):1618-1628.
  8. A retrospective wound review of standard four-port laparoscopic cholecystectomy: is there need for single-port laparoscopic surgery? Surg Endosc 2012 Jan;26(1):255-260.
  9. Assessment of cosmetic outcome after laparoscopic cholecystectomy among women 4 years after laparoscopic cholecystectomy: is there a problem? Surg Endosc 2011 Aug;25(8):2574-2577.
  10. How well do patients recall past experience of pain? Nursing times 2007 Nov;103(42):34-35.
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