Jan 14, 2016

A Review Of 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.

There are a number of advantages that are associated with this procedure. One of them is the fact that recovery is faster and many patients can resume their routine duties in a few days. It is also cosmetically superior to the other methods due to the fact that only one incision is used. The main disadvantage is that it is a little more expensive than the other methods due to the high level of specialization needed.

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 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.

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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