Single-incision Laparoscopic Surgery (SILS) in General Surgery

Abstract

Single-incision laparoscopic surgery (SILS) aims to eliminate multiple port incisions. Although general operative principles of SILS are similar to conventional laparoscopic surgery, operative techniques are not standardized. This review aims to evaluate the current use of SILS published in the literature by examining the types of operations performed, techniques employed, and relevant complications and morbidity. This review considered a total of 94 studies reporting 1889 patients evaluating 17 different general surgical operations. There were 8 different access techniques reported using conventional laparoscopic instruments and specifically designed SILS ports. There is extensive heterogeneity associated with operating methods and in particular ways of overcoming problems with retraction and instrumentation. Published complications, morbidity, and hospital length of stay are comparable to conventional laparoscopy. Although SILS provides excellent cosmetic results and morbidity seems similar to conventional laparoscopy, larger randomized controlled trials are needed to assess the safety and efficacy of this novel technique.

The role of the laparoendoscopic single site totally extraperitoneal approach to inguinal hernia repairs: a review and meta-analysis of the literature

“…Although some articles suggest cosmesis may be better with LESS TEP, LAP TEP is an acceptable technique with good postoperative outcomes. 57 …”

Rational Manipulation of the Standard Laparoscopic Instruments for Single-Incision Laparoscopic Right Colectomy

“…However, to the best of our knowledge, the literature contains no detailed reports referring to manipulation techniques for standard laparoscopic instruments using the SILS Access Port; hence, our report is the first to describe such techniques. There are many access port devices for singleincision laparoscopic surgery, 1,6 and each has its advantages and limitations. We use the SILS Access Port for right colectomy because it is a flexible laparoscopic port that can accommodate up to 3 instruments, and because its simplicity allows it to maintain adequate pneumoperitoneum.…”

“…1 Single-incision laparoscopic surgery using the SILS Access Port (Covidien, Mansfield, Massachusetts) has realized a number of potential benefits, such as improved cosmetic appearance, reduction of postoperative abdominal pain, and a short postoperative hospital stay. [2][3][4][5] On the other hand, the technique has the drawback of having the 2 instruments and laparoscopes competing for the same space at the fulcrum of the entry port.…”

Successful Ovarian Vitrification and Back-Transplantation to Preserve Fertility in a Patient Requiring Chemotherapy for Malignant Lymphoma

“…Reduced-Port Surgery (RPS) has attracted attention in recent years as a less invasive procedure than conventional laparoscopic surgery [5][6][7][8][9][10]. For patients scheduled to undergo chemotherapy or radiotherapy, it is preferable that recovery from oophorectomy be as rapid as possible; therefore, we considered RPS to be potentially suitable for these patients, and we have reported six cases of fertility preservation achieved by RPS [11].…”