Basics 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.

Laparoscopic operations have traditionally required three entry ports made in the anterior abdominal wall to facilitate the entry of the laparoscope and the instruments. For single incision surgery, only one of these ports is required for both the laparoscope and the instruments. For this reason, the operation is also known as single port access surgery (SPA) or single port Laparoscopy (SPL).

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.

The main challenge on the part of the surgeon is the difficult that is associated with moving the instruments around using the small opening. The crowding caused by the instruments obscures the surgical field. This increases the risk of intraoperative injury especially if the surgeon is not adequately experienced. In the ordinary laparoscopic operation each instrument has a different port hence easier to move around.

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.

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.

Single incision surgery is fast becoming one of the most popular techniques among patients and surgeons. This is mainly due to its minimal invasive nature that results in better cosmetic results. The risks involved are also reduced markedly. The fields of gynecology and pediatrics appear to be on the forefront in embracing this specialized procedure.




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