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Background <p>The standard technique of laparoscopic cholecystectomy requires four ports and at least two operators (surgeon and assistant). The Single-Operator Multi-Port (SOMP) technique, wherein the surgeon independently manipulates all four ports using self-retaining retractors, remains poorly characterized in the literature.</p> Aim <p>To describe the SOMP cholecystectomy technique and evaluate its feasibility, safety, and efficacy through analysis of surgical outcomes in comparison to the standard Multiple-Operator Multi-Port (MOMP) cholecystectomy.</p> Methods <p>We performed a retrospective review of consecutive laparoscopic cholecystectomies from July 2022 to April 2025, by a single surgeon who routinely uses the SOMP technique except when self-retaining retractors are unavailable. Patient demographics, surgical indications, operative time, estimated blood loss, conversion to open surgery, reoperation rate, 30-day readmission, and 30-day mortality were evaluated.</p> Results <p>Among 124 consecutive laparoscopic cholecystectomies, 92 cases (74.2%) used the SOMP technique. In the SOMP cohort, the median age was 48, and 66 (71.7%) were female. Thirty-three procedures (35.9%) were elective. Surgical indications included symptomatic cholelithiasis (n=68), chronic cholecystitis (n=38), choledocholithiasis (n=25), biliary pancreatitis (n=15), and acute cholecystitis (n=14). Additional port placement for better retraction was needed in seven patients (7.6%). Median operative time was 75 minutes, with a median estimated blood loss of 25 mL and three patients (3.3%) required readmission within 30 days. There were no reoperations or mortalities within 30 days. Multivariable analysis demonstrated that the SOMP technique was an independent factor associated with lower operative time (β for MOMP =41.2, p&lt;0.001) and conversion rate to open approach (OR for MOMP = 20.4, p&lt;0.001).</p> Conclusion <p>The SOMP technique using self-retaining retractors is a safe and efficient approach to laparoscopic cholecystectomy, with possible benefits in improved functional design, reduced costs, and staffing needs. </p> Trial Registration (Clinical trial details) <p>Not applicable</p>

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Single-Operator Multi-Port cholecystectomy (SOMP) – technique, safety, and efficacy

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年12月23日

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  • Niraj Balakrishnan,
  • Harold Coley,
  • Kaleb Eaton,
  • William Bukowski,
  • Indy Aronson,
  • Pragatheeshwar Thirunavukarasu

摘要

Background

The standard technique of laparoscopic cholecystectomy requires four ports and at least two operators (surgeon and assistant). The Single-Operator Multi-Port (SOMP) technique, wherein the surgeon independently manipulates all four ports using self-retaining retractors, remains poorly characterized in the literature.

Aim

To describe the SOMP cholecystectomy technique and evaluate its feasibility, safety, and efficacy through analysis of surgical outcomes in comparison to the standard Multiple-Operator Multi-Port (MOMP) cholecystectomy.

Methods

We performed a retrospective review of consecutive laparoscopic cholecystectomies from July 2022 to April 2025, by a single surgeon who routinely uses the SOMP technique except when self-retaining retractors are unavailable. Patient demographics, surgical indications, operative time, estimated blood loss, conversion to open surgery, reoperation rate, 30-day readmission, and 30-day mortality were evaluated.

Results

Among 124 consecutive laparoscopic cholecystectomies, 92 cases (74.2%) used the SOMP technique. In the SOMP cohort, the median age was 48, and 66 (71.7%) were female. Thirty-three procedures (35.9%) were elective. Surgical indications included symptomatic cholelithiasis (n=68), chronic cholecystitis (n=38), choledocholithiasis (n=25), biliary pancreatitis (n=15), and acute cholecystitis (n=14). Additional port placement for better retraction was needed in seven patients (7.6%). Median operative time was 75 minutes, with a median estimated blood loss of 25 mL and three patients (3.3%) required readmission within 30 days. There were no reoperations or mortalities within 30 days. Multivariable analysis demonstrated that the SOMP technique was an independent factor associated with lower operative time (β for MOMP =41.2, p<0.001) and conversion rate to open approach (OR for MOMP = 20.4, p<0.001).

Conclusion

The SOMP technique using self-retaining retractors is a safe and efficient approach to laparoscopic cholecystectomy, with possible benefits in improved functional design, reduced costs, and staffing needs.

Trial Registration (Clinical trial details)

Not applicable