Minilap-assisted modified single-incision

Background: The single-incision laparoscopic cholecystectomy (SILC) achieves a scarless appearance through a single umbilical approach. However, the restricted surgical field of view, frequent instrument collisions limit its clinical applicability. This study introduces minilap-assisted modified single-incision laparoscopic cholecystectomy (MSILC), incorporating two adjacent trocars at the umbilicus, combined with a 2-mm auxiliary hole created beneath the right costal margin, to mitigate these limitations while preserving aesthetic outcomes. Objective: To explore the clinical value of MSILC compared with traditional SILC (TSILC) in reducing instrument conflict, shortening operation time, improving operator efficiency and cosmetic effects, and providing a basis for the selection of surgical procedures for patients with high body mass index (BMI). Methods: A total of 51 patients with benign gallbladder diseases who underwent MSILC or TSILC between December 2021 and April 2025 at our institution were retrospectively enrolled and categorized into the MSILC ( Results: In the MSILC group, the number of instrument conflicts was reduced by 38.5% (median 16 Conclusion: MSILC significantly improves intraoperative efficiency by optimizing the trocar layout, especially in patients with high BMI, while maintaining safety and cosmetic outcomes comparable with those of TSILC. However, cost increases due to the use of microdevices should be taken into consideration.