5. Conclusion Implementing a standardised patient pathway for day-case laparoscopic cholecystectomy has increased day-case rates sixfold, with http://www.selleckchem.com/products/Y-27632.html no associated increase in readmission or conversion rate. Engagement with clerical, nursing, and medical staff, in addition to management of patients’ expectations following surgery was a vital part of this process. Future standardisation of anaesthetic and analgesic regimes may improve this further. Conflict of Interests The authors have no conflict of interests to declare. Acknowledgments The authors are grateful to Nicola Mellor, clinical nurse practitioner, in addition to the theatre, recovery, and ward staff that were so helpful in facilitating data collection.
Laparoscopy has evolved rapidly over the past decade.

We are witnessing a steady evolution towards progressively less invasive techniques. Although the adoption of robotic surgery has been hailed as a landmark in minimally invasive surgery, the huge initial capital outlay and the high maintenance costs are major obstacles. Recently, there is a renewed interest in single port gynaecological surgery, which was first reported by Wheeless in 1969, on the first single-incision tubal ligation [1]. However, laparoendoscopic single-site surgery (LESS) techniques did not take off initially due to limitations in the capabilities of laparoscopic equipment and imaging. Laparoendoscopic single-site surgery (LESS) techniques may be considered as a form of natural orifice transluminal endoscopic surgery (NOTES), via the umbilicus, which has recently emerged as a feasible form of minimally invasive procedure [2�C4].

In fact, LESS techniques show comparable or better improvements in cosmesis and resulted in less postoperative pain than NOTES [5]. Currently, the LESS approach has been used mainly in the arenas of urologic and gastroenteric procedures such as nephrectomy [6], appendectomy [7], cholecystectomy [8], and hemicolectomy [9]. Reports on the use of LESS techniques in gynaecological surgeries are sparse [4]. Instrumentation to perform complex maneuvers intracorporeally are few, and several reports of single port surgery are at best considered as hybrid reports, in which the target organ was exteriorized through the umbilicus and extracorporeal open surgery performed [10�C13]. The fundamental idea of single port surgery is to have all of the laparoscopic working ports enter the abdominal wall through Brefeldin_A the same incision [14, 15], further enhancing the cosmetic benefits of minimally invasive surgery while reducing the potential morbidity associated with multiple trocar incisions found in standard laparoscopic surgery [4, 6, 16, 17].