Page 41 - WJOLS - Laparoscopic Journal

WJOLS

10.5005/jp-journals-10007-1115
REVIEW ARTICLE Different Types of Single Incision Laparoscopy Surgery (SILS) Ports
Different Types of Single Incision Laparoscopy

Surgery (SILS) Ports

Chigurupathi Venkata Pavan Kumar
Assistant Professor, Mamata Medical College and Hospital, Khammam, Andhra Pradesh, India

ABSTRACT

Introduction: Single incision laparoscopic surgery (SILS) has become an advancement in minimal acess surgery because it offers
benefits like less postoperative pain, less invasive and has best cosmetic results. Even though the amount of time taken for SILS
surgery is more, this can be brought down by experience and more advances on the type of instruments used. We are going to review
different types of SILS ports available in the world today.
Material and methods: Articles of relevant studies are searched from the internet using Google, PubMed, Yahoo, HighWire press,
SpringerLink, etc. available at world laparoscopic hospital.
Aims: The main aim of this review is to evaluate different types of SILS ports and their effectiveness in safe laparoscopic surgeries. To
know if they offer any less postoperative pain and best cosmetic results than the multiple trocar surgeries, and to know the best SILS
port.
Conclusion: Whatever might be the choice of single incision laparoscopic surgery or procedure, the best choice of port depends on
many factors like choice of the surgeon, skill of the surgeon, availability of ports, operative time of the procedure and cost effectiveness.
To know this, we need more controlled randomized studies on different types of SILS ports in single procedure. We cannot pinpoint
which might be the best port for SILS at this point of time.
Keywords: Single incision laparoscopic surgery (SILS), LESS, Minimal access surgery, Single port acess (SPA), SILS ports, NOTES.

INTRODUCTION 2. Transumbilical insertion is commonly used and ideal to
prevent any visible scar.
History of single incision laparoscopic surgery dates back
to 1992, where Pelosi performed single puncture 3. Some surgeons placed incision in the pubic hairline
laparoscopic appendectomy. In 1997 Navarra et al medially.
performed laparoscopic cholecystectomies with two trans- 4. Incisions are also given above and below the umbilicus
umbilical trocars. Some of the disorders like gallbladder to give excellent cosmetic results.
stones, the gold standard treatment of choice is laparoscopic But the choice of incisions mainly depends on the
cholecystectomy. But now there are so many advances and surgeons’ preference.
refinements in technology and instrumentation that A lot of surgeons are using 30º laparoscopy light source
cholecystectomy is being done by SILS and NOTES in but several teams also use small diameter laparoscopy with
some of the centers all over the world. These advances angular tip and incorporated light source. 1-3
help in making the surgery less invasive and cosmetically Next is the choice of instrument. Some surgeons have
the outcome is good and superior to other procedures. In been using regular laparoscopic instruments but because of
this article, we are going to review the different literature the advent of new technology, now surgeons are using more
available regarding different types of SILS ports available and more of curved or angular or flexible laparoscopic
in the market and to know if they offer any advantage over instruments. In some cases for multichannel ports, a
one another. Roticulator grasper (Covidien) was used.
Next is the choice of single incision laparoscopy surgery
SURGICAL TECHNIQUE ports. There are many different ports, available but we are

Whatever might be the procedure being done, the basic dealing with only few selected ports which are commonly
principle is same that multiple instruments or multiple trocars used. The choice of port completely depends on the
are placed in a single port of entry. The positions for single surgeons’ choice and preference, availability of port and
port access may be different depending on many factors cost factor.
like choice of surgeon, type of surgery and age of the patient. Once the choice of port is made, they are placed in the
The different locations commonly used are: abdomen for single port access surgery. The dissection
1. A 6 cm long omega-shaped incision made around the and procedure for that particular surgery is performed in
upper half of umbilicus. the same fashion as standard laparoscopic procedure. On

World Journal of Laparoscopic Surgery, January-April 2011;4(1):47-51 47