Page 55 - WJOLS - Laparoscopic Journal

WJOLS

Comparison of Advantages and Disadvantages between SILS and NOTES

Fig. 3: Real hand instruments with angle locking

Figs 4A to C: SILS cholecystectomy
procedures. 16,17 But cholecystectomy is the most common Kirschner’s wire instead of stay sutures for retraction of
19
procedure conducted through SILS and NOTES (Table 1). Calot’s triangle. Average time taken for this surgery was
70 minutes.
TECHNIQUE OF SILS CHOLECYSTECTOMY Rao et al have conducted 20 SILS cholecystectomy
First cholecystectomy by SILS was performed by Navara using R-port, which consists of double layer plastic
et al in 1997. He used two 10 mm trocars and three trans- cylinder that serves as single port. It is introduced through
3
abdominal stay sutures for the procedure. Two years later 15 to 20 mm umbilical incision. The device has three valvular
in 1999, Piskun and Rajpal conducted the same procedure openings, which permit three 5 mm or one 10 mm and one
by using two 5 mm trocars and two stay sutures. In the 5 mm working instruments with angulated shafts. Surgery
above two procedures, both two umbilical trocars for was performed successfully in 85% of cases with an average
telescope and hand instruments are used. Cuesta et al used time of 30 minutes. TriPort is a similar device that has been

World Journal of Laparoscopic Surgery, January-April 2011;4(1):67-72 69