Single-Port-Access-Laparoskopie: Ein Überblick über die jüngste Entwicklung in der minimalinvasiven Chirurgie

Abstract

Nowadays laparoscopy is the approach of choice for the majority of abdominal pathologies. As the emphasis on minimising the technique continues, new methods as natural orifice translumenal endoscopic surgery (NOTES) and, just recently, single port access surgery (SPA) are evolving rapidly. SPA may represent the next generation of minimally invasive surgery as it combines some of the cosmetic advantage of the natural orifice translumenal endoscopic surgery (NOTES) and allows the performance of the surgical procedure with standard surgical instruments. To perform SPA, the abdomen is approached through a 2 cm incision via the umbilicus and a single-port access device is inserted as sole access to the abdomen. Depending on the single-port system, usually a multichannel cannula, two or three laparoscopic instruments can be used at the same time. The special design of the channels prevents gas leakage while changing instruments. There is also an extra channel for the gas insufflation and an additional element for retracting the abdominal wall. Single-port laparoscopic procedures are safe and feasible. Tissue trauma and port-related complications such as organ damage, adhesions, bleedings, wound infections and hernias could be decreased and the cosmesis is comparable with that of NOTES. Additional experience and continued investigation are warranted.

Robotic Liver Resection: Initial Experience With Three-Arm Robotic and Single-Port Robotic Technique

“…In our study we elected to use the single-access approach in the last 2 procedures to minimize trauma and port-related complications, such as organ damage, adhesions, bleedings, wound infections, and hernias. 33,35 …”

Anwendungsbeobachtung zu TachoSil® bei der Cholezystektomie – Eine multizentrische prospektive einarmige Kohortenstudie

“…Die häufigen und gleichzeitig auch schwerwiegenden operationsbedingten Komplikationen sind die postoperative Blutung [5] und die Gallengangsleckage. Die Komplikationsraten der weiterentwickelten laparoskopischen Zugänge [6,7] . Concerning laparoscopic cholecystectomy, it was significant that the surgeons decided to take middle-sized patches (4.8 × 4.8 cm) more frequently.…”

„Matched-Pair“-Analyse der laparoskopischen (LA) vs. Single-Port-Appendektomie (SP) zur initialen Evaluation im Rahmen der Etablierung einer neuen Operationsmethode

“…B. NOTES), andere wie NOS und SP versuchen, einen prozedurenspezifischen Platz im Behandlungsspektrum der akuten Appendizitis einzunehmen [9][10][11][12][13]. Überwiegend werden allerdings bisher nur kleine Fallzahlen berichtet, wobei kaum ein stichhaltiger Vergleich des Patienten-"Outcomes" zu den etablierten Methoden erfolgt [14].…”