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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
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