%0 Journal Article %T Prospective Observational Study of Single-Site Multiport Per-umbilical Laparoscopic Endosurgery versus Conventional Multiport Laparoscopic Cholecystectomy: Critical Appraisal of a Unique Umbilical Approach %A Priyadarshan Anand Jategaonkar %A Sudeep Pradeep Yadav %J Minimally Invasive Surgery %D 2014 %I Hindawi Publishing Corporation %R 10.1155/2014/909321 %X Purpose. This prospective observational study compares an innovative approach of Single-Site Multi-Port Per-umbilical Laparoscopic Endo-surgery (SSMPPLE) cholecystectomy with the gold standard¡ªConventional Multi-port Laparoscopic Cholecystectomy (CMLC)¡ªto assess the feasibility and efficacy of the former. Methods. In all, 646 patients were studied. SSMPPLE cholecystectomy utilized three ports inserted through three independent mini-incisions at the umbilicus. Only the day-to-day rigid laparoscopic instruments were used in all cases. The SSMPPLE cholecystectomy group had 320 patients and the CMLC group had 326 patients. The outcomes were statistically compared. Results. SSMPPLE cholecystectomy had average operative time of 43.8£¿min and blood loss of 9.4£¿mL. Their duration of hospitalization was 1.3 days (range, 1¨C5). Six patients (1.9%) of this group were converted to CMLC. Eleven patients had controlled gallbladder perforations at dissection. The Visual Analogue Scores for pain on postoperative days 0 and 7, the operative time, and the scar grades were significantly better for SSMPPLE than CMLC. However, umbilical sepsis and seroma outcomes were similar. We had no bile-duct injuries or port-site hernias in this study. Conclusion. SSMPPLE cholecystectomy approach complies with the principles of laparoscopic triangulation; it seems feasible and safe method of minimally invasive cholecystectomy. Overall, it has a potential to emerge as an economically viable alternative to single-port surgery. 1. Introduction Conventional Multi-port Laparoscopic Cholecystectomy (CMLC) is the gold-standard for tackling benign gallbladder diseases; it generally requires 4 (sometimes even 5 or more) ports spread across different quadrants of abdomen. Recently, the surgeons¡¯ quest for reducing the access-trauma by reducing the number of ports has led to several technical modifications regarding minimally invasive cholecystectomy [1, 2]. And the natural-orifice transluminal endoscopic surgery (NOTES) with its potential to achieve completely scarless abdomen, though the most sought for, seems to have fallen out of favor owing to the technical complexity, the prolonged learning curve, and the questionable safety due to the issues regarding closure of mucosal breach. Logically, the per-umbilical approach, with its potential to produce almost the similar results, has been warmly welcomed by the surgeons and the industry. However, this ¡°third generation¡± surgery is far from being accepted as the standardized approach due to the lack of ease and uniformity in %U http://www.hindawi.com/journals/mis/2014/909321/