Single-incision Laparoscopic Cholecystectomy: Technical Challenges, Clinical Breakthroughs, and a New Chapter for the Future

Zhui Ke; Peng Ji; Huanwen Li; Yi Chen; Fang Wang; Guobao Yang

doi:doi:10.11648/j.ajcem.20251306.13

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Single-incision Laparoscopic Cholecystectomy: Technical Challenges, Clinical Breakthroughs, and a New Chapter for the Future

Zhui Ke, Peng Ji, Huanwen Li, Yi Chen, Fang Wang, Guobao Yang^*

Published in American Journal of Clinical and Experimental Medicine (Volume 13, Issue 6)

Received: 9 November 2025 Accepted: 22 December 2025 Published: 27 December 2025

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Abstract

Single-incision laparoscopic cholecystectomy (SILC) represents a significant direction in the evolution of minimally invasive surgery. Performed through a single umbilical incision, SILC offers the distinct advantage of achieving a "scarless" abdominal wall and significantly improving patient cosmetic satisfaction. However, this technique faces considerable technical challenges, including the "chopstick effect" inherent to coaxial instrument manipulation, limited visual field, and a steep learning curve. These factors may contribute to an elevated risk of complications such as bile duct injury and incisional hernia. Currently, SILC is primarily indicated for carefully selected patients with low-to-moderate surgical complexity benign gallbladder diseases. While it achieves comparable major clinical outcomes to conventional laparoscopic cholecystectomy (LC), debates persist regarding its operative duration, postoperative pain profiles, and health economic implications. To address these technical bottlenecks, innovative modifications such as suspension exposure techniques, magnetic anchor technology, and robotic single-port platforms continue to emerge. This review contends that SILC serves not as a replacement for conventional LC, but as a valuable complement, specifically designed to meet the higher demands for aesthetics and minimal invasiveness in particular patient populations. Future advancement of SILC urgently requires robust high-quality evidence, establishment of standardized training protocols, and systematic progress in instrument innovation and healthcare reimbursement policies. Such developments are essential to steer SILC towards a more precise and personalized surgical paradigm.

Published in	American Journal of Clinical and Experimental Medicine (Volume 13, Issue 6)
DOI	10.11648/j.ajcem.20251306.13
Page(s)	177-183
Creative Commons	This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.
Copyright	Copyright © The Author(s), 2025. Published by Science Publishing Group

Keywords

Single-incision Laparoscopic Cholecystectomy, Cholecystectomy, Minimally Invasive Surgery, Learning Curve

References

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APA Style

Ke, Z., Ji, P., Li, H., Chen, Y., Wang, F., et al. (2025). Single-incision Laparoscopic Cholecystectomy: Technical Challenges, Clinical Breakthroughs, and a New Chapter for the Future. American Journal of Clinical and Experimental Medicine, 13(6), 177-183. https://doi.org/10.11648/j.ajcem.20251306.13

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ACS Style

Ke, Z.; Ji, P.; Li, H.; Chen, Y.; Wang, F., et al. Single-incision Laparoscopic Cholecystectomy: Technical Challenges, Clinical Breakthroughs, and a New Chapter for the Future. Am. J. Clin. Exp. Med. 2025, 13(6), 177-183. doi: 10.11648/j.ajcem.20251306.13

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AMA Style

Ke Z, Ji P, Li H, Chen Y, Wang F, et al. Single-incision Laparoscopic Cholecystectomy: Technical Challenges, Clinical Breakthroughs, and a New Chapter for the Future. Am J Clin Exp Med. 2025;13(6):177-183. doi: 10.11648/j.ajcem.20251306.13

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@article{10.11648/j.ajcem.20251306.13,
  author = {Zhui Ke and Peng Ji and Huanwen Li and Yi Chen and Fang Wang and Guobao Yang},
  title = {Single-incision Laparoscopic Cholecystectomy: Technical Challenges, Clinical Breakthroughs, and a New Chapter for the Future},
  journal = {American Journal of Clinical and Experimental Medicine},
  volume = {13},
  number = {6},
  pages = {177-183},
  doi = {10.11648/j.ajcem.20251306.13},
  url = {https://doi.org/10.11648/j.ajcem.20251306.13},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ajcem.20251306.13},
  abstract = {Single-incision laparoscopic cholecystectomy (SILC) represents a significant direction in the evolution of minimally invasive surgery. Performed through a single umbilical incision, SILC offers the distinct advantage of achieving a "scarless" abdominal wall and significantly improving patient cosmetic satisfaction. However, this technique faces considerable technical challenges, including the "chopstick effect" inherent to coaxial instrument manipulation, limited visual field, and a steep learning curve. These factors may contribute to an elevated risk of complications such as bile duct injury and incisional hernia. Currently, SILC is primarily indicated for carefully selected patients with low-to-moderate surgical complexity benign gallbladder diseases. While it achieves comparable major clinical outcomes to conventional laparoscopic cholecystectomy (LC), debates persist regarding its operative duration, postoperative pain profiles, and health economic implications. To address these technical bottlenecks, innovative modifications such as suspension exposure techniques, magnetic anchor technology, and robotic single-port platforms continue to emerge. This review contends that SILC serves not as a replacement for conventional LC, but as a valuable complement, specifically designed to meet the higher demands for aesthetics and minimal invasiveness in particular patient populations. Future advancement of SILC urgently requires robust high-quality evidence, establishment of standardized training protocols, and systematic progress in instrument innovation and healthcare reimbursement policies. Such developments are essential to steer SILC towards a more precise and personalized surgical paradigm.},
 year = {2025}
}

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TY  - JOUR
T1  - Single-incision Laparoscopic Cholecystectomy: Technical Challenges, Clinical Breakthroughs, and a New Chapter for the Future
AU  - Zhui Ke
AU  - Peng Ji
AU  - Huanwen Li
AU  - Yi Chen
AU  - Fang Wang
AU  - Guobao Yang
Y1  - 2025/12/27
PY  - 2025
N1  - https://doi.org/10.11648/j.ajcem.20251306.13
DO  - 10.11648/j.ajcem.20251306.13
T2  - American Journal of Clinical and Experimental Medicine
JF  - American Journal of Clinical and Experimental Medicine
JO  - American Journal of Clinical and Experimental Medicine
SP  - 177
EP  - 183
PB  - Science Publishing Group
SN  - 2330-8133
UR  - https://doi.org/10.11648/j.ajcem.20251306.13
AB  - Single-incision laparoscopic cholecystectomy (SILC) represents a significant direction in the evolution of minimally invasive surgery. Performed through a single umbilical incision, SILC offers the distinct advantage of achieving a "scarless" abdominal wall and significantly improving patient cosmetic satisfaction. However, this technique faces considerable technical challenges, including the "chopstick effect" inherent to coaxial instrument manipulation, limited visual field, and a steep learning curve. These factors may contribute to an elevated risk of complications such as bile duct injury and incisional hernia. Currently, SILC is primarily indicated for carefully selected patients with low-to-moderate surgical complexity benign gallbladder diseases. While it achieves comparable major clinical outcomes to conventional laparoscopic cholecystectomy (LC), debates persist regarding its operative duration, postoperative pain profiles, and health economic implications. To address these technical bottlenecks, innovative modifications such as suspension exposure techniques, magnetic anchor technology, and robotic single-port platforms continue to emerge. This review contends that SILC serves not as a replacement for conventional LC, but as a valuable complement, specifically designed to meet the higher demands for aesthetics and minimal invasiveness in particular patient populations. Future advancement of SILC urgently requires robust high-quality evidence, establishment of standardized training protocols, and systematic progress in instrument innovation and healthcare reimbursement policies. Such developments are essential to steer SILC towards a more precise and personalized surgical paradigm.
VL  - 13
IS  - 6
ER  -

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Author Information

Zhui Ke

Department of Critical Care Medicine, Xiangshui County People's Hospital, Yancheng, China
Peng Ji

Department of Critical Care Medicine, Xiangshui County People's Hospital, Yancheng, China
Huanwen Li

Department of Critical Care Medicine, Xiangshui County People's Hospital, Yancheng, China
Yi Chen

Department of Critical Care Medicine, Xiangshui County People's Hospital, Yancheng, China
Fang Wang

Department of Critical Care Medicine, Xiangshui County People's Hospital, Yancheng, China
Guobao Yang

Department of Critical Care Medicine, Xiangshui County People's Hospital, Yancheng, China

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APA Style

Ke, Z., Ji, P., Li, H., Chen, Y., Wang, F., et al. (2025). Single-incision Laparoscopic Cholecystectomy: Technical Challenges, Clinical Breakthroughs, and a New Chapter for the Future. American Journal of Clinical and Experimental Medicine, 13(6), 177-183. https://doi.org/10.11648/j.ajcem.20251306.13

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ACS Style

Ke, Z.; Ji, P.; Li, H.; Chen, Y.; Wang, F., et al. Single-incision Laparoscopic Cholecystectomy: Technical Challenges, Clinical Breakthroughs, and a New Chapter for the Future. Am. J. Clin. Exp. Med. 2025, 13(6), 177-183. doi: 10.11648/j.ajcem.20251306.13

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AMA Style

Ke Z, Ji P, Li H, Chen Y, Wang F, et al. Single-incision Laparoscopic Cholecystectomy: Technical Challenges, Clinical Breakthroughs, and a New Chapter for the Future. Am J Clin Exp Med. 2025;13(6):177-183. doi: 10.11648/j.ajcem.20251306.13

Copy | Download

@article{10.11648/j.ajcem.20251306.13,
  author = {Zhui Ke and Peng Ji and Huanwen Li and Yi Chen and Fang Wang and Guobao Yang},
  title = {Single-incision Laparoscopic Cholecystectomy: Technical Challenges, Clinical Breakthroughs, and a New Chapter for the Future},
  journal = {American Journal of Clinical and Experimental Medicine},
  volume = {13},
  number = {6},
  pages = {177-183},
  doi = {10.11648/j.ajcem.20251306.13},
  url = {https://doi.org/10.11648/j.ajcem.20251306.13},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ajcem.20251306.13},
  abstract = {Single-incision laparoscopic cholecystectomy (SILC) represents a significant direction in the evolution of minimally invasive surgery. Performed through a single umbilical incision, SILC offers the distinct advantage of achieving a "scarless" abdominal wall and significantly improving patient cosmetic satisfaction. However, this technique faces considerable technical challenges, including the "chopstick effect" inherent to coaxial instrument manipulation, limited visual field, and a steep learning curve. These factors may contribute to an elevated risk of complications such as bile duct injury and incisional hernia. Currently, SILC is primarily indicated for carefully selected patients with low-to-moderate surgical complexity benign gallbladder diseases. While it achieves comparable major clinical outcomes to conventional laparoscopic cholecystectomy (LC), debates persist regarding its operative duration, postoperative pain profiles, and health economic implications. To address these technical bottlenecks, innovative modifications such as suspension exposure techniques, magnetic anchor technology, and robotic single-port platforms continue to emerge. This review contends that SILC serves not as a replacement for conventional LC, but as a valuable complement, specifically designed to meet the higher demands for aesthetics and minimal invasiveness in particular patient populations. Future advancement of SILC urgently requires robust high-quality evidence, establishment of standardized training protocols, and systematic progress in instrument innovation and healthcare reimbursement policies. Such developments are essential to steer SILC towards a more precise and personalized surgical paradigm.},
 year = {2025}
}

Copy | Download

TY  - JOUR
T1  - Single-incision Laparoscopic Cholecystectomy: Technical Challenges, Clinical Breakthroughs, and a New Chapter for the Future
AU  - Zhui Ke
AU  - Peng Ji
AU  - Huanwen Li
AU  - Yi Chen
AU  - Fang Wang
AU  - Guobao Yang
Y1  - 2025/12/27
PY  - 2025
N1  - https://doi.org/10.11648/j.ajcem.20251306.13
DO  - 10.11648/j.ajcem.20251306.13
T2  - American Journal of Clinical and Experimental Medicine
JF  - American Journal of Clinical and Experimental Medicine
JO  - American Journal of Clinical and Experimental Medicine
SP  - 177
EP  - 183
PB  - Science Publishing Group
SN  - 2330-8133
UR  - https://doi.org/10.11648/j.ajcem.20251306.13
AB  - Single-incision laparoscopic cholecystectomy (SILC) represents a significant direction in the evolution of minimally invasive surgery. Performed through a single umbilical incision, SILC offers the distinct advantage of achieving a "scarless" abdominal wall and significantly improving patient cosmetic satisfaction. However, this technique faces considerable technical challenges, including the "chopstick effect" inherent to coaxial instrument manipulation, limited visual field, and a steep learning curve. These factors may contribute to an elevated risk of complications such as bile duct injury and incisional hernia. Currently, SILC is primarily indicated for carefully selected patients with low-to-moderate surgical complexity benign gallbladder diseases. While it achieves comparable major clinical outcomes to conventional laparoscopic cholecystectomy (LC), debates persist regarding its operative duration, postoperative pain profiles, and health economic implications. To address these technical bottlenecks, innovative modifications such as suspension exposure techniques, magnetic anchor technology, and robotic single-port platforms continue to emerge. This review contends that SILC serves not as a replacement for conventional LC, but as a valuable complement, specifically designed to meet the higher demands for aesthetics and minimal invasiveness in particular patient populations. Future advancement of SILC urgently requires robust high-quality evidence, establishment of standardized training protocols, and systematic progress in instrument innovation and healthcare reimbursement policies. Such developments are essential to steer SILC towards a more precise and personalized surgical paradigm.
VL  - 13
IS  - 6
ER  -

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