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Basics Relating To Single Incision Laparoscopic Surgery

By Edward Thomas


Surgery has evolved in a great way in the last few decades. Unlike in the past, when the main objective was to restore functionality, cosmesis appear to carry a lot of significance these days. In Ne York city for example, patients are increasingly requesting for smaller incisions so as to reduce the sizes of scars. This is perhaps what gave rise to laparoscopic surgery and most recently, single incision laparoscopic surgery. In this article we explore what exactly this operation is and what its benefits and downsides are.

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.

This operating technique is used for many different conditions. These include, among others, gall bladder removal, appendectomy, hernia repair, pelvic operations such as the removal of the ovary and the uterus. This list is set to increase even further as many surgeons make the switch to the new approach.

There are a number of benefits that are associated with using this technique. One of them is the fact that the recovery time is shorter. Most of the people that have been operated on can return to work in a week. With only one incision, the cosmetic results are a lot better than with conventional laparoscopic operations. The main disadvantage on the patient is that they may have to pay a little more mainly due to the high level of specialization.

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.

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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