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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.


Laparoscopic surgeries use three to five openings that are much smaller than the incision used for open surgeries. In single incision surgery only one is required. General anesthesia is usually required just as is the case with many other operations. Other terms used to describe the technique include single port laparoscopy, SPL, and single port access surgery, SPA.

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.

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.

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.

Single incision surgery is a specialist procedure that continues to rise in popularity among surgeons and patients. Due to its minimal invasive nature, the risks that are usually associated with operations are markedly reduced. Gynecology and pediatrics are the two fields of medicine that have readily embraced the technique.




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