High Quality Single port access for Laparoscopy surgery

Single-port laparoscopy (SPL), is a recently developed technique in laparoscopic surgery. It is a minimally invasive surgical procedure in which the surgeon operates almost exclusively through a single entry point, typically the patient's navel. Unlike a traditional multi-port laparoscopic approach, SPL leaves only a single small scar.

SPL is accomplished through a single 20 mm incision in the navel (umbilicus or belly button), or through only an 11 mm incision in the navel, minimizing the scarring and incisional pain associated with the multiple points of entry used during traditional laparoscopic surgery.

Laparoendoscopic single-site surgery (LESS) has been developed to benefit patients by enabling surgeons to perform scarless surgery. Clinical data demonstrate that LESS is safe and effective in many pediatric urology settings. As clinical experience increases, expanding indications are expected, along with improved efficacy. Prospective randomized studies are awaited to determine whether LESS procedures will be established as routine and will be able to stand the test of time. Technological advances hold promise to minimize the challenging technical nature of scarless surgery.

Advantages of SILS

The putative benefits of SILS over conventional laparoscopy include better cosmesis due to relatively hidden umbilical scar, less postoperative pain, rapid convalescence, decreased morbidity related to visceral and vascular injury during trocar placement, risk reduction of postoperative wound infection and hernia formation, and elimination of multiple trocar site closures. Studies have also suggested that women who undergo SILS reported improved postoperative pain profiles when compared with those receiving conventional laparoscopic surgery.This may be due to the utilization of the umbilicus, which is one of the thinnest regions on the abdominal wall containing few blood vessels, muscle, or nerves, as the single site of the incision.

Application

The SPL technique has been used to perform many types of surgery, including adjustable gastric banding,appendectomy cholecystectomy, colectomy, hernia repair, hysterectomy, sleeve gastrectomy,nephrectomy, and sacrocolpopexy. Although a number of single-incision techniques use specialized instrumentation, most SPL operations in the United States and Europe have used standard instrumentation. The Single port can be inserted with its introducer through a 15 mm incision at the umbilicus. This device allows four instruments to be used simultaneously. During LESS cholecystectomy a fourth instrument becomes essential to gain critical view. Up until now surgeons have been inventive in how to retract the infundibulum; sutures and other novel means of retraction have all been reported. The instrument's channel allows for a fixed curved infundibular grasper to be added; this helps replicate the methodology currently being practised in traditional four-port laparoscopic cholecystectomy.