Background : Laparoscopic cholecystectomy (LC) is the optimal treatment for symptomatic cholelithiasis. There is various surgical method using 1-4ports in LC. Although multiport LC is most commonly performed, there is still patient demand for less scarring and less pain. Single-port laparoscopic cholecystectomy (SPLC) is a surgical method comparable to multiport LC and meets the needs of these patients. However, SPLC is still technically difficult and stressful procedure due to internal collision between laparoscopic instruments and limitation of movement. Conventional straight-fixed laparoscopic instruments have disadvantages of limited freedom of movement and angle in single-port surgery. Therefore, it was hard for surgeons to get a safe and good surgical view during SPLC.

Methods : To overcome this limitation, we used the ArtiSential® (LIVSMED Inc., Republic of Korea), a new laparoscopic articulating instrument during pure SPLC. ArtiSential® has multi-joint structure that are synchronized with the surgeon’s hand, wrist, and finger movement. ArtiSential® allows a wide range of movement like a robotic arm and a cost-effectiveness compared to robotic surgery. We used three kinds of ArtiSential® devices including monopolar hook, bipolar Maryland dissector, and fenestrated forcep in single Glove port® (Nelis Corp., Republic of Korea) system.

Results : In this video, we intended to show how to overcome internal collision and make a good surgical view through a new laparoscopic articulating instrument during pure SPLC.

Conclusions : Pure SPLC using a new laparoscopic articulating instrument (ArtiSential®) is safe and technically feasible. Further study is mandatory.