Facts Relating To 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.

There are a number of surgical operations that can be performed using this technique. They include gallbladder removal, repair of inguinal and incisional hernias, appendectomy and the removal of pelvic organs such as the ovary and the uterus among others. This list continues to grow by the day as better instruments are invented to make it easier to perform such operations.

There are a number of advantages that are associated with this procedure. One of them is the fact that recovery is faster and many patients can resume their routine duties in a few days. It is also cosmetically superior to the other methods due to the fact that only one incision is used. The main disadvantage is that it is a little more expensive than the other methods due to the high level of specialization needed.

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.

The option is not suitable for persons that are very obese, those with a history of other operations and those with a grossly enlarged abdominal organ. In the event that it is not possible to complete the operation using the single incision, an additional port will be created to proceed with the traditional approach. This happens in 5% to 10% of cases. The open technique may be required in rare circumstances.

Just as is the case with any surgical operation, risks exist. Bleeding and infections are the most common but their incidence is a lot lower than what is seen with other techniques. Incisional hernias, a common complications of open operations, is a very rare occurrence.

This surgical technique has a wide range of applications. It is set to be the main technique in the management of pediatric and gynecological surgical problems. Many training institutions have now incorporated the practice into their curricula and plan to retrain specialist surgeons and residents.




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