Basics Of Single Incision Laparoscopic Surgery

By Margaret Bailey


Approaches to surgical operation are changing and evolving mostly because of major technological advancements that are being made in various fields including surgical medicine. Single incision laparoscopic surgery is often referred to using the abbreviation SILS, but it also has many other names. Among the names SILS goes by are Single-port laparoscopy, single-port access surgery (SPA), Single-access endoscopic surgery (SAES), and single-port incisionnless conventional equipment-using surgery (SPICES). Other names include natural-orifice trannsumbilical surgery (NOTUS), one-port umbilical surgery (OPUS), and laparo-endoscopic singular-site surgery (LESS).

SILS as a technique under laparoscopic surgery is still a relatively new idea with a rather short history. It falls under minimally invasive techniques of surgical operations because of its use of one incision point. In many patients, the navel serves as the entry point. Small scars are formed from the process. The small size of the scar is among the reasons for high preference of the method by patients and surgeons.

Entry points are either 11mm or 22 mm incisions. One incision is utilized to minimize scarring and pain felt during and after the process. The use of one incision is opposed to the traditional laparoscopic procedure that uses multiple entry points. There are some of the most highly qualified specialists in SILS in New York. Therefore, it is quite advisable to consider visiting the city when in search of specialists in this process.

The process makes use of specialized surgical equipment that can be classified into two major classes, that is hand and access ports instruments. There is a wide variety of access ports instruments including the GelPOINT system, SILS device, TriPort+, QuadPort+, TriPort15, and Uni-X. All these instruments are manufactured by different manufacturers.

Conversely, there are three key configurations of hand instruments in use. They include articulating, pre-bent rigid, and standard configurations. It has taken over the past thirty years to develop standard hand tools. They are made with rigid design. The SPL reduced triangulation instrument problem was solved by the development of articulation hand instruments.

The choice of whether or not to use articulating or standard instruments usually lies with the surgeons. There are a few factors that influence the decision. Among these influential factors are access port used, cost, and surgical skills of a surgeon. Articulating instruments are very costly when compared to standard instruments. This procedure is made safer and more effective by the use of specialized instruments.

There is a high level of awareness of SILS among surgical doctors currently. However, it cannot be performed by any surgeon. The process is very complicated since it involves using specialized instruments through limited access space. Thus, surgical doctors who perform this process are often highly skilled and trained in surgical operation. That has made the use of this process limited and negative perceptions have followed from the public too.

A wide variety of surgeries makes use of SILS. Common examples comprise of sleeve gastrectomy, colectomy, adjustable gastric banding, appendectomy, nephrectomy, sacrocolpopexy, and hysterectomy among others. In European nations and the US, standard instruments are in wide usage when compared to specialized ones used in many other countries out of these two regions.




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