Oral fluids were offered after a mean of 6.7 hours Sorafenib B-Raf in the CLC group, 6.3 hours in the 3-port groups and 6.1 hours in the SILS group, thus the three groups were comparable. Duration of hospitalization was also comparable, with a mean duration of 1.8 days (range 1�C2.5). The esthetic results and patient satisfaction were evaluated using the Patient and Observer Scar Assessment Scale (POSAS) (24). The esthetic results were significantly better in the SILS group than in the CLC group at 1 and 6 months (P �� 0.05). Discussion From its first use (25), single incision laparoscopic cholecystectomy has evolved progressively, encouraged by increasing patient �C and thus industrial �C interest. So, in the first cases of single-access cholecystectomy many authors used the ��Swiss cheese technique�� with the introduction of various trocars through the same umbilical incision.

In parallel the industries developed several ��multiport�� specialized trocars. This new method simplified the surgical approach and probably also improved the final esthetic result. The endpoint in this retrospective study was to demonstrate the feasibility and safety of SILS cholecystectomy as an alternative to multiport techniques in selected patients (26, 27). All procedures were carried out in selected patients by surgeons expert in laparoscopy. In contrast to the initial results of laparoscopic cholecystectomy (28), the SILS approach proved safe: there were no intraoperative complications in any patients. Moreover, its feasibility was demonstrated by the fact that there were no conversions to classic laparoscopy and additional subxiphoid trocars were needed in just two cases.

The greatest surgical difficulty is undoubtedly the isolation of Calot��s triangle. The benefits of SILS cholecystectomy are, above all, the improved postoperative outcome, with less postoperative pain and consequently reduced use of analgesics. The duration of hospitalization, in contrast, was comparable for all three groups. The other great benefit of SILS cholecystectomy is the final cosmetic result, the reason that this technique is preferred by the young and by women. The positioning of the trocar using Hasson��s technique via trans-umbilical open laparoscopy is essential to achieve this. After surgery, there is in fact a single, invisible scar, leading this technique to be called ��no-scar�� surgery.

The drawbacks include the longer operating time, although this is partly due to the individual surgeon��s learning curve (29, 30). Furthermore, while we did not experience any major intraoperative complications, there are numerous literature Batimastat reports of iatrogenic injuries to the main bile duct, possibly requiring conversion to open surgery and significantly affecting the patient��s postoperative outcome.