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Open Access 01-12-2024 | Review

Evolution of minimally invasive cholecystectomy: a narrative review

Authors: Changjin Nam, Jun Suh Lee, Ji Su Kim, Tae Yoon Lee, Young Chul Yoon

Published in: BMC Surgery | Issue 1/2024

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Abstract

Background

Laparoscopic cholecystectomy, being a prevalent abdominal surgical procedure, has transitioned through various innovative stages aimed at reducing the procedure's invasiveness. These stages encompass Single-Incision Laparoscopic Cholecystectomy (SILC), Mini Laparoscopic Cholecystectomy (MLC), Natural Orifice Transluminal Endoscopic Surgery (NOTES), and Robotic-Assisted Laparoscopic Cholecystectomy (RALC). The purpose of this review is to trace the evolution of minimally invasive cholecystectomy techniques, assess their status, and identify emerging trends and challenges in the field.

Method

An extensive review was performed to explore the evolution and characteristics of SILC, MLC, NOTES, and RALC. The approach involved an in-depth examination of literature available on PubMed, coupled with a critical assessment of surgical outcomes, associated complications, and technical hurdles posed by these methods.

Results

SILC, despite its potential for reduced scarring, exhibits an elevated risk of bile duct damage and incisional hernia occurrences. MLC, mirroring the standard technique closely, presents minor benefits without amplifying postoperative complications, hence, positing itself as a feasible choice for routine elective cholecystectomy. NOTES, although still facing technical challenges, the hybrid transvaginal procedure is gaining clinical interest. RALC, heralded for its augmented precision and dexterity, emerges as a potential future avenue, although necessitating further exploration to ascertain its efficacy and safety.

Conclusion

The progression of laparoscopic cholecystectomy methodologies embodies the surgical society's aspiration to minimize invasiveness whilst enhancing patient outcomes. This review endeavors to offer a structured discourse on SILC, MLC, NOTES, and RALC, aspiring to aid the ongoing deliberation on the judicious selection of surgical techniques in clinical practice.
Appendix
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Literature
1.
2.
3.
McMahon AJ, Baxter JN, Anderson JR, Ramsay G, O’Dwyer PJ, Russell IT, et al. Laparoscopic versus minilaparotomy cholecystectomy: a randomised trial. Lancet. 1994;343:135–8.PubMedCrossRef
4.
Gollan JL, Bulkley GB, Diehl AM, Elashoff JD, Federle MP, Hogan WJ, et al. Gallstones and Laparoscopic Cholecystectomy. JAMA. 1993;269:1018–24.CrossRef
5.
Yuan RH, Lee WJ, Yu SC. Mini-laparoscopic cholecystectomy: a cosmetically better, almost scarless procedure. J Laparoendosc Adv Surg Tech A. 1997;7:205–11.PubMedCrossRef
6.
Ngoi SS, Goh P, Kok K, Kum CK, Cheah WK. Needlescopic or minisite cholecystectomy. Surg Endosc. 1999;13:303–5.PubMedCrossRef
7.
Navarra G. One-wound laparoscopic cholecystectomy. Br J Surg. 1997;84(5):695.PubMed
8.
Ahmed K, Wang TT, Patel VM, Nagpal K, Clark J, Ali M, et al. The role of single-incision laparoscopic surgery in abdominal and pelvic surgery: a systematic review. Surg Endosc. 2011;25:378–96.PubMedCrossRef
9.
Marescaux J, Dallemagne B, Perretta S, Wattiez A, Mutter D, Coumaros D. Surgery without scars: report of transluminal cholecystectomy in a human being. Arch Surg. 2007;142:823–6.PubMedCrossRef
10.
Gagner M, Begin E, Hurteau R, Pomp A. Robotic Interactive laparoscopic cholecystectomy. Lancet. 1994;343:596–7.PubMedCrossRef
11.
Allemann P, Demartines N, Schäfer M. Remains of the day: Biliary complications related to single-port laparoscopic cholecystectomy. World J Gastroenterol. 2014;20:843–51.PubMedPubMedCentralCrossRef
12.
Arezzo A, Scozzari G, Famiglietti F, Passera R, Morino M. Is single-incision laparoscopic cholecystectomy safe? Results of a systematic review and meta-analysis. Surg Endosc. 2013;27:2293–304.PubMedCrossRef
13.
Evers L, Bouvy N, Branje D, Peeters A. Single-incision laparoscopic cholecystectomy versus conventional four-port laparoscopic cholecystectomy: a systematic review and meta-analysis. Surg Endosc. 2017;31:3437–48.PubMedCrossRef
14.
Lin H, Zhang J, Li X, Li Y, Su S. Comparative outcomes of single-incision laparoscopic, mini-laparoscopic, four-port laparoscopic, three-port laparoscopic, and single-incision robotic cholecystectomy: a systematic review and network meta-analysis. Updat Surg. 2023;75:41–51.CrossRef
15.
Haueter R, Schütz T, Raptis DA, Clavien PA, Zuber M. Meta-analysis of single-port versus conventional laparoscopic cholecystectomy comparing body image and cosmesis. Br J Surg. 2017;104:1141–59.PubMedCrossRef
16.
Joseph M, Phillips MR, Farrell TM, Rupp CC. Single incision laparoscopic cholecystectomy is associated with a higher bile duct injury rate: a review and a word of caution. Ann Surg. 2012;256:1–6.PubMedCrossRef
17.
Lirici MM, Tierno SM, Ponzano C. Single-incision laparoscopic cholecystectomy: does it work? A systematic review. Surg Endosc. 2016;30:4389–99.PubMedCrossRef
18.
Markar SR, Karthikesalingam A, Thrumurthy S, Muirhead L, Kinross J, Paraskeva P. Single-incision laparoscopic surgery (SILS) vs. conventional multiport cholecystectomy: Systematic review and meta-analysis. Surg Endosc. 2012;26(5):1205–13.PubMedCrossRef
19.
Milas M, Devedija S, Trkulja V. Single incision versus standard multiport laparoscopic cholecystectomy: Up-dated systematic review and meta-analysis of randomized trials. Surgeon. 2014;12:271–89.PubMedCrossRef
20.
Kim MK, Choi IS, Moon JI, Lee SE, Yoon DS, Kwon SU, et al. Evolution of the Konyang Standard Method for single incision laparoscopic cholecystectomy: the result from a thousand case of a single center experience. Ann Surg Treat Res. 2018;95:80–6.PubMedPubMedCentralCrossRef
21.
Romanelli JR, Earle DB. Single-port laparoscopic surgery: an overview. Surg Endosc. 2009;23:1419–27.PubMedCrossRef
22.
Strohmeier U, Dupré G, Bockstahler B, Tichy A, Liehmann L. Comparison of a single-access glove port with a SILSTM port in a surgical simulator model using MISTELS. BMC Vet Res. 2021;17(1):285.PubMedPubMedCentralCrossRef
23.
Tai HC, Da LC, Wu CC, Tsai YC, Yang SSD. Homemade transumbilical port: an alternative access for laparoendoscopic single-site surgery (LESS). Surg Endosc. 2010;24:705–8.PubMedCrossRef
24.
Antoniou SA, Morales-Conde S, Antoniou GA, Pointner R, Granderath FA. Single-incision laparoscopic cholecystectomy with curved versus linear instruments assessed by systematic review and network meta-analysis of randomized trials. Surg Endosc. 2016;30:819–31.PubMedCrossRef
25.
Wu S, Lv C, Tian Y, Fan Y, Yu H, Kong J, et al. Transumbilical single-incision laparoscopic cholecystectomy: long-term review from a single center. Surg Endosc. 2016;30:3375–85.PubMedCrossRef
26.
Strasberg SM, Brunt LM. Rationale and use of the critical view of safety in laparoscopic cholecystectomy. J Am Coll Surg. 2010;211:132–8.PubMedCrossRef
27.
Li T, Kim G, Chang S. Tips and tricks to avoid bile duct injury in SILC: an experience of 500 cases. Surg Endosc. 2016;30:4750–5.PubMedCrossRef
28.
Igami T, Nojiri M, Shinohara K, Ebata T, Yokoyama Y, Sugawara G, et al. Clinical value and pitfalls of fluorescent cholangiography during single-incision laparoscopic cholecystectomy. Surg Today. 2016;46:1443–50.PubMedCrossRef
29.
Alptekin H, Yilmaz H, Acar F, Kafali ME, Sahin M. Incisional hernia rate may increase after single-port cholecystectomy. J Laparoendosc Adv Surg Tech. 2012;22:731–7.CrossRef
30.
Hoyuela C, Juvany M, Guillaumes S, Ardid J, Trias M, Bachero I, et al. Long-term incisional hernia rate after single-incision laparoscopic cholecystectomy is significantly higher than that after standard three-port laparoscopy: a cohort study. Hernia. 2019;23:1205–13.PubMedCrossRef
31.
Christoffersen MW, Brandt E, Oehlenschläger J, Rosenberg J, Helgstrand F, Jørgensen LN, et al. No difference in incidence of port-site hernia and chronic pain after single-incision laparoscopic cholecystectomy versus conventional laparoscopic cholecystectomy: a nationwide prospective, matched cohort study. Surg Endosc. 2015;29:3239–45.PubMedCrossRef
32.
Jensen SAMS, Fonnes S, Gram-Hanssen A, Andresen K, Rosenberg J. Low long-term incidence of incisional hernia after cholecystectomy: A systematic review with meta-analysis. Surgery (United States). 2021;169:1268–77.
33.
Julliard O, Hauters P, Possoz J, Malvaux P, Landenne J, Gherardi D. Incisional hernia after single-incision laparoscopic cholecystectomy: incidence and predictive factors. Surg Endosc. 2016;30:4539–43.PubMedCrossRef
34.
Hall TC, Dennison AR, Bilku DK, Metcalfe MS, Garcea G. Single-incision laparoscopic cholecystectomy a systematic review. Arch Surg. 2012;147(7):657–66.PubMedCrossRef
35.
Matsui Y, Yamaki S, Hirooka S, Yamamoto T, Yanagimoto H, Satoi S, et al. Evaluation of relative criteria for single-incision laparoscopic cholecystectomy. Asian J Surg. 2018;41:216–21.PubMedCrossRef
36.
Lee W, Roh YH, Kang SH, Kim CY, Choi YR, Han HS, et al. The chronological change of indications and outcomes for single-incision laparoscopic cholecystectomy: a Korean multicenter study. Surg Endosc. 2021;35:3025–32.PubMedCrossRef
37.
Abdelrahman AM, Bingener J, Yu D, Lowndes BR, Mohamed A, McConico AL, et al. Impact of single-incision laparoscopic cholecystectomy (SILC) versus conventional laparoscopic cholecystectomy (CLC) procedures on surgeon stress and workload: a randomized controlled trial. Surg Endosc. 2016;30:1205–11.PubMedCrossRef
38.
Pérez-Duarte FJ, Lucas-Hernández M, Matos-Azevedo A, Sánchez-Margallo JA, Díaz-Güemes I, Sánchez-Margallo FM. Objective analysis of surgeons’ ergonomy during laparoendoscopic single-site surgery through the use of surface electromyography and a motion capture data glove. Surg Endosc. 2014;28:1314–20.PubMedCrossRef
39.
Kimura T, Sakuramachi S, Yoshida M, Kobayashi T, Takeuchi Y. Laparoscopic cholecystectomy using fine-caliber instruments. Surg Endosc. 1998;12:283–6.PubMedCrossRef
40.
Reardon PR, Kamelgard JI, Applebaum B, Rossman L, Brunicardi FC. Feasibility of laparoscopic cholecystectomy with miniaturized instrumentation in 50 consecutive cases. World J Surg. 1999;23:128–32.PubMedCrossRef
41.
Lee PC, Lai IR, Yu SC. Minilaparoscopic (needlescopic) cholecystectomy: A study of 1,011 cases. Surg Endosc Other Interv Tech. 2004;18:1480–4.
42.
Alhashemi M, Almahroos M, Fiore JF, Kaneva P, Gutierrez JM, Neville A, et al. Impact of miniport laparoscopic cholecystectomy versus standard port laparoscopic cholecystectomy on recovery of physical activity: a randomized trial. Surg Endosc. 2017;31:2299–309.PubMedCrossRef
43.
Zhao JJ, Syn NL, Chong C, Tan HL, Ng JYX, Yap A, et al. Comparative outcomes of needlescopic, single-incision laparoscopic, standard laparoscopic, mini-laparotomy, and open cholecystectomy: A systematic review and network meta-analysis of 96 randomized controlled trials with 11,083 patients. Surgery (United States). 2021;170:994–1003.
44.
Tan X, Wang G, Tang Y, Bai J, Tao K, Ye L. Minilaparoscopic versus single incision cholecystectomy for the treatment of cholecystolithiasis: a meta-analysis and systematic review. BMC Surg. 2017;17(1):91.PubMedPubMedCentralCrossRef
45.
46.
Kalloo AN, Singh VK, Jagannath SB, Niiyama H, Hill SL, Vaughn CA, et al. Flexible transgastric peritoneoscopy: a novel approach to diagnostic and therapeutic interventions in the peritoneal cavity. Gastrointest Endosc. 2004;60:114–7.PubMedCrossRef
47.
Bulian DR, Knuth J, Lehmann KS, Sauerwald A, Heiss MM. Systematic analysis of the safety and benefits of transvaginal hybrid-NOTES cholecystectomy. World J Gastroenterol: WJG. 2015;21:10915.PubMedPubMedCentralCrossRef
48.
Peng C, Ling Y, Ma C, Ma X, Fan W, Niu W, et al. Safety outcomes of NOTES cholecystectomy versus laparoscopic cholecystectomy: a systematic review and meta-analysis. Surg Laparosc Endosc Percutan Tech. 2016;26:347.PubMedPubMedCentralCrossRef
49.
Sodergren MH, Markar S, Pucher PH, Badran IA, Jiao LR, Darzi A. Safety of transvaginal hybrid NOTES cholecystectomy: a systematic review and meta-analysis. Surg Endosc. 2015;29:2077–90.PubMedCrossRef
50.
Liu L, Chiu PWY, Reddy N, Ho KY, Kitano S, Seo DW, et al. Natural orifice transluminal endoscopic surgery (NOTES) for clinical management of intra-abdominal diseases. Dig Endosc. 2013;25:565–77.PubMedCrossRef
51.
Horgan S, Thompson K, Talamini M, Ferreres A, Jacobsen G, Spaun G, et al. Clinical experience with a multifunctional, flexible surgery system for endolumenal, single-port, and NOTES procedures. Surg Endosc. 2011;25:586–92.PubMedCrossRef
52.
Zornig C, Siemssen L, Emmermann A, Alm M, Von Waldenfels HA, Felixmüller C, et al. NOTES cholecystectomy: matched-pair analysis comparing the transvaginal hybrid and conventional laparoscopic techniques in a series of 216 patients. Surg Endosc. 2011;25:1822–6.PubMedCrossRef
53.
Noguera JF, Cuadrado A, Dolz C, Olea JM, García JC. Prospective randomized clinical trial comparing laparoscopic cholecystectomy and hybrid natural orifice transluminal endoscopic surgery (NOTES) (NCT00835250). Surg Endosc. 2012;26:3435–41.PubMedCrossRef
54.
Senft JD, Gath P, Dröscher T, Müller PC, Carstensen B, Nickel F, et al. New device for transrectal trocar placement and rectal sealing for NOTES: a porcine in vivo and human cadaver study. Surg Endosc. 2016;30:4383–8.PubMedCrossRef
55.
Bulian DR, Knuth J, Cerasani N, Sauerwald A, Lefering R, Heiss MM. Transvaginal/transumbilical hybrid-NOTES-versus 3-trocar needlescopic cholecystectomy: short-term results of a randomized clinical trial. Ann Surg. 2015;261:451–8.PubMedCrossRef
56.
Pohlen U, Feller A, Holmer C. Transvaginal hybrid NOTES cholecystectomy: a single-centre long-term experience on sexual function. World J Surg. 2018;42:1960–4.PubMedCrossRef
57.
Bulian DR, Knuth J, Thomaidis P, Rieger A, Seefeldt CS, Lange J, et al. Does obesity influence the results in Transvaginal Hybrid-NOTES cholecystectomy? Surg Endosc. 2018;32:4632–8.PubMedCrossRef
58.
Bulian DR, Walper S, Richards DC, Schulz SA, Seefeldt CS, Thomaidis P, et al. Comparative analysis of postoperative pain after transvaginal hybrid NOTES versus traditional laparoscopic cholecystectomy in obese patients. Surg Endosc. 2022;36:4983–91.PubMedCrossRef
59.
Bulian DR, Sauerwald A, Thomaidis P, Seefeldt CS, Richards DC, Schulz SA, et al. Does a prior hysterectomy complicate transvaginal/transumbilical hybrid NOTES cholecystectomy?—a comparative analysis of prospectively collected data. Langenbecks Arch Surg. 2022;407:655–62.PubMedCrossRef
60.
Aguayo E, Dobaria V, Nakhla M, Seo YJ, Hadaya J, Cho NY, et al. National trends and outcomes of inpatient robotic-assisted versus laparoscopic cholecystectomy. Surgery (United States). 2020;168:625–30 Mosby Inc.
61.
Huang Y, Chua TC, Maddern GJ, Samra JS. Robotic cholecystectomy versus conventional laparoscopic cholecystectomy: a meta-analysis. Surgery (United States). 2017;161:628–36.
62.
Kane WJ, Charles EJ, Mehaffey JH, Hawkins RB, Meneses KB, Tache-Leon CA, et al. Robotic compared with laparoscopic cholecystectomy: a propensity matched analysis. Surgery (United States). 2020;167:432–5.
63.
Strosberg DS, Nguyen MC, Muscarella P, Narula VK. A retrospective comparison of robotic cholecystectomy versus laparoscopic cholecystectomy: operative outcomes and cost analysis. Surg Endosc. 2017;31:1436–41.PubMedCrossRef
64.
Tao Z, Emuakhagbon VS, Pham T, Augustine MM, Guzzetta A, Huerta S. Outcomes of robotic and laparoscopic cholecystectomy for benign gallbladder disease in veteran patients. J Robot Surg. 2021;15:849–57.PubMedCrossRef
65.
Byun Y, Choi YJ, Kang JS, Han Y, Kim H, Kwon W, et al. Robotic extended cholecystectomy in gallbladder cancer. Surg Endosc. 2020;34:3256–61.PubMedCrossRef
66.
Tschuor C, Lyman WB, Passeri M, Salibi PN, Baimas-George M, Iannitti DA, et al. Robotic-assisted completion cholecystectomy: a safe and effective approach to a challenging surgical scenario – a single center retrospective cohort study. Int J Med Robot Comp Assist Surg. 2021;17(6):e2312.CrossRef
67.
Peters BS, Armijo PR, Krause C, Choudhury SA, Oleynikov D. Review of emerging surgical robotic technology. Surg Endosc. 2018;32:1636–55.PubMedCrossRef
68.
Han DH, Choi SH, Kang CM, Lee WJ. Propensity score-matching analysis for single-site robotic cholecystectomy versus single-incision laparoscopic cholecystectomy: a retrospective cohort study. Int J Surg. 2020;78:138–42.PubMedCrossRef
69.
Jones VS. Robotic-assisted single-site cholecystectomy in children. J Pediatr Surg. 2015;50:1842–5.PubMedCrossRef
70.
Svoboda S, Qaqish TR, Wilson A, Park H, Youssef Y. Robotic single-site cholecystectomy in the obese: outcomes from a single institution. Surg Obes Relat Dis. 2015;11:882–5.PubMedCrossRef
71.
72.
Kang YH, Kang JS, Cho YS, Kim HS, Lee M, Han Y, et al. A retrospective multicentre study on the evaluation of perioperative outcomes of single-port robotic cholecystectomy comparing the Xi and SP versions of the da Vinci robotic surgical system. Int J Med Robot Comp Assist Surg. 2022;18(1):e2345.CrossRef
73.
Wang G, Yi B, Li Z, Zhu L, Hao L, Zeng Y, et al. Micro-hand robot-assisted versus da vinci robot-assisted cholecystectomy: a multi-centre, randomized controlled trial. World J Surg. 2022;46:2632–41.PubMedCrossRef
74.
Kelkar DS, Kurlekar U, Stevens L, Wagholikar GD, Slack M. An early prospective clinical study to evaluate the safety and performance of the versius surgical system in robot-assisted cholecystectomy. Ann Surg. 2023;277:9–17.PubMedCrossRef
75.
Barbash GI, Glied SA. New technology and health care costs — the case of robot-assisted surgery. N Engl J Med. 2010;363:701–4.PubMedCrossRef
76.
Rosemurgy A, Ryan C, Klein R, Sukharamwala P, Wood T, Ross S. Does the cost of robotic cholecystectomy translate to a financial burden? Surg Endosc. 2015;29:2115–20.PubMedCrossRef
Metadata
Title
Evolution of minimally invasive cholecystectomy: a narrative review
Authors
Changjin Nam
Jun Suh Lee
Ji Su Kim
Tae Yoon Lee
Young Chul Yoon
Publication date
01-12-2024
Publisher
BioMed Central
Published in
BMC Surgery / Issue 1/2024
Electronic ISSN: 1471-2482
DOI
https://doi.org/10.1186/s12893-024-02659-x

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