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Basics Of Single Incision Laparoscopic Surgery

By Margaret Bailey


Approaches to surgical operation are changing and evolving mostly because of major technological advancements that are being made in various fields including surgical medicine. Single incision laparoscopic surgery is often referred to using the abbreviation SILS, but it also has many other names. Among the names SILS goes by are Single-port laparoscopy, single-port access surgery (SPA), Single-access endoscopic surgery (SAES), and single-port incisionnless conventional equipment-using surgery (SPICES). Other names include natural-orifice trannsumbilical surgery (NOTUS), one-port umbilical surgery (OPUS), and laparo-endoscopic singular-site surgery (LESS).

SILS as a technique under laparoscopic surgery is still a relatively new idea with a rather short history. It falls under minimally invasive techniques of surgical operations because of its use of one incision point. In many patients, the navel serves as the entry point. Small scars are formed from the process. The small size of the scar is among the reasons for high preference of the method by patients and surgeons.

Entry points are either 11mm or 22 mm incisions. One incision is utilized to minimize scarring and pain felt during and after the process. The use of one incision is opposed to the traditional laparoscopic procedure that uses multiple entry points. There are some of the most highly qualified specialists in SILS in New York. Therefore, it is quite advisable to consider visiting the city when in search of specialists in this process.

Specialized surgical instruments in use by SILS fall into two wide categories. These wide categories are access ports instruments and hand instruments. Some of the access ports instruments are TriPort15, the Uni-X, SILS gadgets, TriPort+, GelPOINT system, and QuadPort+. The devices are designed and made by different companies.

Conversely, three major configurations of hand instruments exist today. They are pre-bent rigid, standard, and articulating configurations. The development of standard hand tools has been happening for more than the previous 30 years. Rigid design is used in making them. SPL reduced triangulation instrument challenge has been solved through the invetion of articulation hand instruments.

A choice always has to be made between standard and articulating instruments by surgeons. Certain factors play a role in influencing that decision. Among those factors are cost, access port utilized, the level of training and skills commanded by the surgeon. It costs much more to use articulating instruments compared to using standard ones. However, the use of specialized tools promotes safety and efficiency.

The degree of awareness of SILS among surgeons is very high. However, the performance of SILS is limited to a few surgeons owing to its high level of complexity, limited space of access, and the use of specialized instruments. Surgical doctors who perform the procedure have to be highly skills and trained in surgical processes. That has promoted negative perception from the public and limited indulgence in the process.

A wide variety of surgeries makes use of SILS. Common examples comprise of sleeve gastrectomy, colectomy, adjustable gastric banding, appendectomy, nephrectomy, sacrocolpopexy, and hysterectomy among others. In European nations and the US, standard instruments are in wide usage when compared to specialized ones used in many other countries out of these two regions.




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