LAPAROSCOPIC CHOLECYSTECTOMY SILS (TRANSUMBILICAL SINGLE-INCISION SURGERY) – BETWEEN LIMITS AND POSSIBILITIES

THE WORK’S PURPOSE WAS TO ANALYSE THE FEASIBILITY OF THE SILS APPROACH IN PATIENTS WITH CHOLELITHIASIS, BOTH WITH CHRONIC AND ACUTE FORMS, THE SPECIFICATION OF THE INDICATIONS AS WELL AS THE LIMITATIONS OF THIS METHOD. THE STUDY WAS RETROSPECTIVE, CONDUCTED ON A LOT OF 736 PATIENTS OPERATED IN THE CLINIC BETWEEN JANUARY 2012 – DECEMBER 2018, WITH A FIRST ATTEMPT OF SILS LAPAROSCOPIC CHOLECYSTECTOMY. OF THE 736 CASES SELECTED FOR SILS SURGERY, 79 % (N=580) WERE COMPLETED IN THIS MANNER, THE REST OF 21% (N=156) IMPOSING EITHER THE INSERTION, SUBHEPATIC OR IN ANOTHER AREA, OF AN ADDITIONAL TROCAR, OR THE PLACEMENT OF A SUBHEPATIC DRAIN (SILS+1). OF THE 580 CASES OPERATED BY SILS, 25% (N=145) WERE ACUTE CHOLECYSTITIS. OF THE 156 CASES OPERATED BY SILS+1 - 91.2% (N=142) WERE ACUTE CHOLECYSTITIS, ADVANCED FORMS, THE REST OF 8.82% (N=14) BEING FORMS OF CHRONIC CHOLECYSTITIS, IN PATIENTS ASSOCIATING SIGNIFICANT COMORBIDITIES. NONE OF THE CASES OPERATED BY SILS OR SILS+1 RECORDED SIGNIFICANT INTRAOPERATIVE COMPLICATIONS, NO CONVERSION WAS PERFORMED, THE REMOTE POSTOPERATIVE COMPLICATIONS WERE IN A PERCENTAGE OF 15.44 % (N=38 CASES); RE- INTERVENTIONS (LATE AND EARLY POSTOPERATIVE HEMOPERITONEUM), WERE REPRESENTED BY A NUMBER OF 3 PATIENTS (0.98%). SILS CHOLECYSTECTOMY CAN BE A FIRST OPTION BOTH FOR CHRONIC AND ACUTE CHOLECYSTITIS; THIS TECHNIQUE ALLOWS THE CONVERSION TO AN ADAPTED FORM (SILS+1) OR TO THE

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