Commentary on "Comparison of cosmetic outcome between single-incision laparoscopic cholecystectomy and conventional laparoscopic cholecystectomy: an objective study".

BACKGROUND Single-incision laparoscopic cholecystectomy (SILC) has been projected to have better cosmetic outcome compared with conventional laparoscopic cholecystectomy (CLC). However, there are scarce data that have objectively compared the patient's perception of cosmetic outcome after SILSC and CLC. METHODS The SILC and CLC patients, who were operated in the last 2 years, were personally interviewed and assessed using the Patient Scar Assessment Questionnaire. A lower score indicated a better patient outcome. The satisfaction with the appearance and the symptoms due to the scars was assessed in all the patients. RESULTS Fifty-two patients were included in the study (25 SILC, 27 CLC). The age and sex distributions and body mass indexes were similar in both groups. The scores of different parameters assessed as per Patient Scar Assessment Questionnaire-appearance (SILC, 1.08 ± 0.4; CLC, 1.14 ± 0.5: P=.57), symptoms (SILC, 1.16 ± 0.5; CLC, 1.18 ± 0.4; P=.83), scar consciousness (SILC, 1.04 ± 0.2; CLC, 1.07 ± 0.3; P=.6), satisfaction with symptoms (SILC, 1.12 ± 0.3; CLC, 1.18 ± 0.4; P=.52), and satisfaction with appearance (SILC, 1.04 ± 0.2; CLC, 1.11 ± 0.3; P=.34)-were similar in both groups. The overall satisfaction scores were also statistically similar in both groups (SILC, 5.44 ± 1.4; CLC, 5.70 ± 1.7; P=.54). Overall, a majority of patients (>80%) in both groups gave the lowest score (1), indicating maximum satisfaction, in all the categories. CONCLUSIONS Patient perception regarding cosmetic outcome after SILC and CLC was similar in both groups. SILC does not seem to offer any significant cosmetic advantage over CLC. This point needs to be assessed in detail by larger studies, as cosmetic benefit is projected as one of the major advantages of single-incision surgery.