Clinical application of modified suspension-assisted transumbilical single-incision laparoscopic cholecystectomy in overweight/obese patients.

OBJECTIVE

Single-incisionlaparoscopic cholecystectomy (SILC) is an extremely popular technique due to its minimal invasiveness and superior cosmetic outcomes. However, identification of the bile duct and management of the limited operative space remain significant challenges in obese patients. This study evaluated a modified suspension-assisted transumbilical SILC technique for overweight/obese individuals.

METHODS

We retrospectively analyzed the clinical data of 106 overweight or obese patients with benign gallbladder diseases treated at our hospital between November 2022 and November 2024. We divided the patients into two groups: in the observation group, 44 patients underwent modified suspension-assisted transumbilical SILC, and in the control group, 62 patients underwent conventional three-port laparoscopic cholecystectomy. We measured several comparative parameters, including preoperative BMI, abdominal circumference, and C-reactive protein (CRP) levels. Moreover, we evaluated surgical and recovery outcomes, including operative time (from induction of anesthesia to skin closure), intraoperative blood loss, conversion to additional trocars, postoperative hospital stay, intraoperative and postoperative complications, duration of incisional pain, time to first flatus, cost of hospitalization, and patient satisfaction with cosmetic outcomes.

RESULTS

All procedures were completed. No significant differences were observed between the observation and control groups in baseline characteristics, including sex, age, BMI, abdominal circumference, and preoperative CRP levels (P > 0.05). No significant differences were observed in operative time, intraoperative blood loss, or the rates of documented postoperative complications (P > 0.05). However, the observation group had a significantly shorter postoperative hospital stay, shorter duration of incisional pain, and earlier time to first flatus than the control group (P < 0.05). Additionally, patients in the observation group reported significantly greater satisfaction with cosmetic outcomes (P < 0.05). Patients in neither group experienced complications such as biliary stricture or incisional hernia during the one-year follow-up.

CONCLUSION

When the modified suspension-assisted transumbilical SILC technique is mastered, it has significant advantages for overweight/obese patients with benign gallbladder diseases, including minimal trauma, rapid recovery, shorter hospital stays, and more desirable cosmetic results. Its application is quite promising in the clinical setting.