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World J Gastrointest Surg. Oct 27, 2015; 7(10): 243-248
Published online Oct 27, 2015. doi: 10.4240/wjgs.v7.i10.243
New minimally invasive approaches for cholecystectomy: Review of literature
Martin Gaillard, Hadrien Tranchart, Panagiotis Lainas, Ibrahim Dagher
Martin Gaillard, Hadrien Tranchart, Panagiotis Lainas, Department of Digestive Minimally Invasive Surgery, Antoine-Beclere Hospital, F-92140 Clamart, France
Martin Gaillard, Hadrien Tranchart, Panagiotis Lainas, Ibrahim Dagher, Faculté de Médecine, Paris-Sud University, F-91405 Orsay, France
Author contributions: Gaillard M performed data acquisition and the majority of the writing; Tranchart H designed the outline and performed the writing; Lainas P performed revision of the writing; Dagher I provided the input in writing the paper and coordinated the writing of the paper.
Conflict-of-interest statement: There is no conflict of interest associated with any of the senior author or other coauthors contributed their efforts in this manuscript.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Ibrahim Dagher, MD, PhD, Professor, Department of Digestive Minimally Invasive Surgery, Antoine-Beclere Hospital, 157 rue de la Porte de Trivaux, F-92140 Clamart, France. ibrahim.dagher@abc.aphp.fr
Telephone: +33-1-45374545 Fax: + 33-1-45374978
Received: April 28, 2015
Peer-review started: May 5, 2015
First decision: July 17, 2015
Revised: July 31, 2015
Accepted: September 10, 2015
Article in press: September 16, 2015
Published online: October 27, 2015
Processing time: 188 Days and 13.6 Hours
Abstract

Laparoscopic cholecystectomy is the most commonly performed abdominal intervention in Western countries. In an attempt to reduce the invasiveness of the procedure, surgeons have developed single-incision laparoscopic cholecystectomy (SILC), minilaparoscopic cholecystectomy (MLC) and natural orifice transluminal endoscopic surgery (NOTES). The aim of this review was to determine the role of these new minimally invasive approaches for elective laparoscopic cholecystectomy in the treatment of gallstone related disease. Current literature remains insufficient for the correct assessment of emerging techniques for laparoscopic cholecystectomy. None of these procedures has demonstrated clear benefits over conventional laparoscopic cholecystectomy. SILC cannot be currently recommended as it can be associated with an increased risk of bile duct injury and incisional hernia incidence. NOTES cholecystectomy is still experimental, although hybrid transvaginal cholecystectomy is gaining popularity in clinical practice. As it is standardized and almost identical to the standard laparoscopic technique, MLC could lead to limited benefits without exposing patients to increased postoperative complications, being therefore adoptable for routine elective cholecystectomy. Technical challenges of SILC and NOTES cholecystectomy could be addressed with the evolution of new surgical tools that need to catch up with the innovative minds of surgeons. Regardless the place of these approaches in the future, robotization may be necessary to impose them as standard treatment.

Keywords: Cholecystectomy; Laparoscopy; Single-incision laparoscopic surgery; Minilaparoscopy; Natural orifice transluminal endoscopic surgery; Review

Core tip: In an attempt to reduce the invasiveness of laparoscopic cholecystectomy, surgeons have developed single-incision laparoscopic cholecystectomy (SILC), minilaparoscopic cholecystectomy (MLC) and natural orifice transluminal endoscopic surgery (NOTES), which are hereby evaluated. SILC cannot be recommended as it can be associated with an increased risk of bile duct injury. NOTES cholecystectomy is still experimental, although hybrid transvaginal cholecystectomy is gaining popularity. As it is standardized and almost identical to the standard laparoscopic technique, MLC could lead to limited benefits without exposing patients to increased postoperative complications, being therefore adoptable for routine elective cholecystectomy.