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A Review Of Single Incision Laparoscopic Surgery

By Edward Thomas


Surgery is one of the fields in medicine that continues to evolve very rapidly. The advances that have been made in the field have made it possible to perform major operations with very few complications. Apart from restoring of function in diseased organs, many patients care about the cosmetic appearance of their skin as much as they want to function normally again. This is the main reason as to why minimally invasive techniques such as single incision laparoscopic surgery are replacing open surgeries in New York city.

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.

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.

It is important to mention that using the technique is a lot more cumbersome than the traditional methods. Using the same opening for all the instruments may not be that easy for surgeons who are not adequately experienced. This is because instrument crowding obscures the view and the distance from the incision site to the target site is often longer. As a result, the risk of intraoperative injury is higher than in other methods without proper training.

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.

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.

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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