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.

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.

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.

The technique is a bit difficult to execute in persons that are very obese. The same challenges may be encountered in persons who have an organ that is massively enlarged or those that have undergone other abdominal surgeries in the past. At times, it is not possible to complete the operation using the single incision. Whenever that happens more ports are created or a conventional (longer) incision made.

There are risks that you need to be aware of even as you consider undergoing the operation. Bleeding and surgical site infections are the most frequently encountered but their incidence is far less than what is seen with the other methods. Incisional hernias are a common problem with open surgery but with this technique they 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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