FAQ

Advantages and challenges of single-port laparoscopy

Single-port laparoscopy (LESS) has gradually become an important development in the field of minimally invasive surgery in recent years, with significant advantages and challenges.

Advantage
Less trauma: Single-port laparoscopy enters through a single puncture hole in the navel, reducing the number of incisions and thereby reducing trauma.

Better aesthetic effect: Due to the natural depression of the umbilicus, the folds can cover up the incision, leaving almost no scars after the operation, achieving a "traceless" effect.

Faster postoperative recovery: Single-port laparoscopic surgery is less invasive, postoperative pain is significantly reduced, and patients can be discharged from the hospital within 2-3 days, with faster recovery.

Shorter hospital stay: Due to less trauma and faster recovery, patients’ hospital stay is also shortened.

Reduce complications: Traditional laparoscopic surgery is sometimes prone to incisional hernia, while such complications are very rare in single-port laparoscopic surgery.

challenge
Instrument crowding and collision: In single-port laparoscopic surgery, all instruments are concentrated in the same incision, which is prone to instrument crowding and collision, affecting the surgical operation.

Ergonomic difficulties: Since there is only one operating space, the operator's operating range is limited, which increases the difficulty of the operation.

Lack of triangulation instrumentation: Single-port laparoscopic surgery lacks the triangulation capabilities found in multiport laparoscopy, resulting in loss of depth perception and limited field of view.

Difficulty in suturing: It is difficult to perform suturing operations under single-port laparoscopy, especially when delicate operations are required.
High technical requirements: Single-port laparoscopic surgery has high technical requirements for doctors and requires advanced laparoscopic surgery technology.

Single-port laparoscopic technology has significant advantages in minimally invasiveness and aesthetics, but it also faces challenges in instrument management, ergonomics, and suturing technology. With the continuous advancement of technology and the accumulation of doctors' experience, these challenges are expected to be gradually overcome.

What are the specific effects and data support of single-port laparoscopic technology in reducing complications?

Single-port laparoscopic technique has a significant effect in reducing complications. Specifically, single-port laparoscopic surgery reduces the number of abdominal puncture holes by concentrating all puncture holes in one incision, thereby reducing the incidence of puncture complications, such as bleeding and infection. Additionally, studies have shown that single-port laparoscopic cholecystectomy has a lower complication rate than traditional multi-port laparoscopic surgery. For example, one study showed that the complication rate for single-port laparoscopic surgery was 4.00%, compared with 14.00% for the control group.

Single-port laparoscopic technique not only reduces the incidence of complications, but also further reduces the risk of postoperative complications by reducing abdominal wall muscle penetration damage. This surgical method is less invasive and has faster postoperative recovery, which can effectively improve patient satisfaction and quality of life.

How to solve the problems of instrument crowding and collision during single-port laparoscopic surgery?

Instrument crowding and collision is a common problem during single-port laparoscopic surgery. In order to solve this problem, the following methods can be taken:

Use grasping forceps and separation forceps with curved front ends: By changing the angle of the instruments during operation, the triangular arrangement can be restored to a certain extent, thus reducing mutual collisions.

Use of surgical instruments with multiple degrees of freedom: The endoscope and surgical instruments in modern single-port laparoscopic surgery systems have multiple active degrees of freedom. The surgical operation can be completed only by the movement of the surgical instruments in the patient's abdominal cavity, which can avoid surgical intervention. Collision between equipment.

Optimize the design of surgical tools: Surgical tools need to meet the corresponding working space, dexterity and load requirements to adapt to the more crowded instrument arrangement in single-port endoscopic surgery.

Improvements in application technology and devices: For example, using single-loop devices and abdominal wall suspension technology to solve the problem of liver occlusion, and placing the specimen in a retrieval bag after resection, and then removing it together with the single-hole device, so that Effectively reduce interference between devices.

Improve surgical skills and teamwork: Through continuous optimization and improvement of surgical techniques, teamwork and high-level instructors, the learning curve can be significantly shortened and surgical efficiency and accuracy can be improved.

How to overcome ergonomic difficulties and improve the operating range and field of view during single-port laparoscopic surgery?

In single-port laparoscopic surgery, methods to overcome ergonomic difficulties and improve the operating range and field of view mainly include the following points:

Improve surgical posture: According to Professor TJ Kim’s recommendations, the operator should adjust the distance between the eyes and the screen and the angle of the elbow. If the operator's eyes are looking straight at the screen at a close distance and the angle between the elbows is greater than 120° during the operation, it will be more ergonomic and comfortable than if the operator looks up at the screen from a distance and the elbow angle is less than 90°.

Use a multi-angle view lens: The 30° forward strabismus lens can obtain a multi-angle view by adjusting the button or rotating the optical cable outside the body, and is more suitable for various types of single-port laparoscopic surgeries.

Placement of a uterine lift device: A uterine lift device can be placed during the operation to help expose the surgical field and reduce the difficulty of suturing.

Special training and simulation system: Since single-port surgery needs to overcome the limitations of the surgical field of view and space, special training and the use of a single-port laparoscopic minimally invasive surgery simulation system can help doctors master relevant skills.

Avoid the "chopstick effect": In single-port laparoscopic surgery, the instruments and the lens are often on the same parallel line, causing the surgical triangle of conventional laparoscopy to disappear. Therefore, it is necessary to re-feel the position of the instruments and the depth of the anatomy, and try to avoid interference between the instruments.

What advanced suturing techniques can improve surgical accuracy in single-port laparoscopic surgery?

In single-port laparoscopic surgery, there are several advanced suturing techniques that can improve surgical accuracy:

Baseball suture method: This suture method was first used in laparoscopic myomectomy and can effectively improve the accuracy of the operation.

Continuous suture method and interrupted suture method: These traditional suture methods are still widely used in single-port laparoscopic surgery, and high-precision suture effects can be achieved through delicate operations.

Figure 8 stitch and U-shaped stitch: These stitches can also provide good stitching results in certain situations, especially when delicate work is required.

Intradermal suturing method: Use 3-0 absorbable suture for intradermal suturing, which is suitable for simple suturing of single-port laparoscopic incisions. This method not only improves suturing accuracy but also reduces postoperative complications.

Barbed thread continuous suture method: In the treatment of ovarian lesions, using Tyco 3-0 barbed thread for continuous suture can effectively close the cyst wall and improve the accuracy of the operation.

Robot-Assisted Suturing: Utilizing specialized suturing tools and state-of-the-art imaging systems, robots can provide more accurate visualization of the surgical area, resulting in improved suturing precision.

Knotting techniques: including simple ligation and ligation + clipping. These techniques are widely used in single-port laparoscopic surgery and can improve the stability and reliability of the surgery.

New evaluation system: A new evaluation system for laparoscopic suturing accuracy based on a stereoscope can help surgeons better master suturing skills and improve surgical accuracy.

What are the specific technical requirements for doctors for single-port laparoscopy?

Single-port laparoscopy technology has very high technical requirements for doctors. The specific standards are as follows:

Surgical technology and proficiency: Single-port laparoscopic surgery is more complex than conventional multi-port laparoscopic surgery, and requires higher surgical skills and proficiency of the operator. Doctors need to have high-level operational skills and rich clinical experience.

Use of high-end equipment: Although there are high-end equipment as a guarantee, the doctor's operating skills are still the key factor.

Preoperative preparation and handling of special situations: Due to the particularity of single-port laparoscopic surgery, it is difficult to estimate the operation time before surgery, and under special circumstances it may be necessary to change to laparotomy.

Training and learning curve: Doctors need to undergo specialized training, master it, and then continuously strengthen operational skills training to quickly improve surgical skills, reduce the learning curve, and reduce the occurrence of complications.

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Company Name: Tonglu Wanhe Medical Instruments Co., Ltd.
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