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.

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.

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.

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.

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.