{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T23:29:18Z","timestamp":1786663758191,"version":"build-2736575974"},"reference-count":32,"publisher":"SAGE Publications","issue":"10","license":[{"start":{"date-parts":[[2026,4,6]],"date-time":"2026-04-06T00:00:00Z","timestamp":1775433600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Laparoendoscopic &amp; Advanced Surgical Techniques"],"published-print":{"date-parts":[[2026,10,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Reduced-port surgery can eliminate the need for a skilled surgical assistant and enable solo surgery with a nonsurgeon camera assistant, potentially addressing surgeon shortages. However, single-incision laparoscopic cholecystectomy has limitations, including instrument collision and prolonged operative time. This study evaluated free jaw (FJ) clip-assisted reduced-port laparoscopic cholecystectomy (RPLC) as a solo-surgery technique.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>\n                      Between January 2022 and December 2025, 14 patients underwent FJ clip-assisted RPLC (three-incision,\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      = 6; two-incision,\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      = 8) performed by a single surgeon with a camera assistant who did not manipulate instruments, and 25 patients underwent four-port conventional laparoscopic cholecystectomy (CLC). The primary outcomes were operative time and the learning curve. The secondary outcomes included blood loss, complications, and postoperative hospital stay. The learning curve was evaluated using cumulative sum (CUSUM) analysis.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      The CUSUM analysis demonstrated a turning point at case 6, indicating completion of the learning curve. The median operative times were comparable between the RPLC and CLC groups (85.5 versus 90.0 minutes,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .121). Estimated blood loss was significantly lower in the RPLC group (1 versus 5 mL,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .013). No complications related to intercostal puncture or FJ clip-induced gallbladder damage were observed. No postoperative complications (Clavien\u2013Dindo \u2265II) were observed in either group.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>FJ clip-assisted RPLC is a feasible solo-surgery technique with a short learning curve. This technique achieved safety comparable to CLC with minimal additional cost, potentially addressing surgeon shortages while maintaining surgical quality.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/10926429261440385","type":"journal-article","created":{"date-parts":[[2026,4,7]],"date-time":"2026-04-07T01:57:17Z","timestamp":1775527037000},"page":"720-726","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Reduced-Port Laparoscopic Cholecystectomy Using a Port-Free Organ Retractor: A Comparative Study with Conventional Four-Port Technique"],"prefix":"10.1177","volume":"36","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6602-0042","authenticated-orcid":false,"given":"Nao","family":"Yoshida","sequence":"first","affiliation":[{"name":"Department of Surgery, Division of Digestive Surgery, Nihon University School of Medicine, Tokyo, Japan."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yukiyasu","family":"Okamura","sequence":"additional","affiliation":[{"name":"Department of Surgery, Division of Digestive Surgery, Nihon University School of Medicine, Tokyo, Japan."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shu","family":"Inagaki","sequence":"additional","affiliation":[{"name":"Department of Surgery, Division of Digestive Surgery, Nihon University School of Medicine, Tokyo, Japan."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masataka","family":"Shindate","sequence":"additional","affiliation":[{"name":"Department of Surgery, Division of Digestive Surgery, Nihon University School of Medicine, Tokyo, Japan."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shunsuke","family":"Yamagishi","sequence":"additional","affiliation":[{"name":"Department of Surgery, Division of Digestive Surgery, Nihon University School of Medicine, Tokyo, Japan."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takaharu","family":"Kawai","sequence":"additional","affiliation":[{"name":"Department of Surgery, Division of Digestive Surgery, Nihon University School of Medicine, Tokyo, Japan."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hayato","family":"Abe","sequence":"additional","affiliation":[{"name":"Department of Surgery, Division of Digestive Surgery, Nihon University School of Medicine, Tokyo, Japan."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yusuke","family":"Mitsuka","sequence":"additional","affiliation":[{"name":"Department of Surgery, Division of Digestive Surgery, Nihon University School of Medicine, Tokyo, Japan."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yasuhiro","family":"Okumura","sequence":"additional","affiliation":[{"name":"Department of Surgery, Division of Digestive Surgery, Nihon University School of Medicine, Tokyo, Japan."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Osamu","family":"Aramaki","sequence":"additional","affiliation":[{"name":"Department of Surgery, Division of Digestive Surgery, Nihon University School of Medicine, Tokyo, Japan."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kosuke","family":"Narumiya","sequence":"additional","affiliation":[{"name":"Department of Surgery, Division of Digestive Surgery, Nihon University School of Medicine, Tokyo, Japan."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,4,6]]},"reference":[{"key":"e_1_3_4_2_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00268-008-9874-4"},{"key":"e_1_3_4_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1758-5910.2011.00087.x"},{"key":"e_1_3_4_4_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00464-011-1985-6"},{"key":"e_1_3_4_5_1","first-page":"347607","article-title":"Single-incision laparoscopic cholecystectomy: Is it a plausible alternative to the traditional four-port laparoscopic approach","volume":"2012","author":"Arroyo JP","year":"2012","unstructured":"4.Arroyo JP, , Mart\u00edn-Del-Campo LA, , Torres-Villalobos G. 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