A Review Of Single Incision Laparoscopic Surgery

By Edward Thomas


There is a major shift in the way in which surgeries are performed in the city of New York. Traditionally, the main objective of surgical operations was to get rid of the diseased part of the body or to restore normal function by any other means. There was little regard about the cosmetic effects these surgeries would have. Today, cosmetic appearance after surgery a lot more important. Single incision laparoscopic surgery is one of the approaches that are being adopted to address this need.

As the name suggests, this is minimally invasive type of surgery in which a single port of entry is used. This entry point is in most cases the navel of the patient. Like many other types of surgeries, this operation is done under general anesthesia. It is also known as single port laparoscopy (SPL) or single port access surgery (SPA). The traditional laparoscopic technique requires three separate incisions to be made.

The technique is used for a wide range of conditions. These include gall bladder removal (cholesystectomy), removal of the appendix, repair of hernias and in pelvic surgeries such as the removal of the uterus and the ovary. As it continues to gain acceptance in the community of surgeons, this list is bound to increase even further.

One of the advantages is that there is less pain as compared to the traditional approach of laparoscopy. As a result, the patients tend to heal a lot faster. It also yields better results cosmetically bearing in mind that only a small opening is made. The main undoing would be the fact that it is marginally expensive than the traditional methods primarily due to the specialized equipment that is used.

There is significant technical challenge is the surgeon is not experienced enough with the technique. Challenges mainly arise from the difficulty of maneuvering the instruments in the same opening. The crowding caused by these instruments makes it difficult to the field clearly. Taking this into account, the risk of intraoperative injury is actually higher in less experienced hands as compared to other methods.

This technique is not suitable for use in patients that are very obese, those that have a massively enlarged abdominal organ and those with a history of multiple operations. This is because of the difficulties that are associated with operating these groups of patients. In case, the operation cannot be completed successfully (as happens in 5 to 10% of cases). Additional ports can be created or even conversion to the open procedure in rare cases.

In spite of the huge success that is attributable to this type of operation, there are some risks that one should be aware of before signing up for it. Bleeding and infections are the most commonly encounter. However, fewer cases are seen as compared to those associated with open surgery and ordinary laparoscopic operations. Incisional hernias that are fairly common with the open technique are a rare occurrence.

Single incision surgery is a specialist procedure that continues to rise in popularity among surgeons and patients. Due to its minimal invasive nature, the risks that are usually associated with operations are markedly reduced. Gynecology and pediatrics are the two fields of medicine that have readily embraced the technique.




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