Page 20 - WJOLS - Laparoscopic Journal

Recent Advances in Laparoscopic Hysterectomy: Journey from Multiple Incision to Single Incision Hysterectomy

General Comparison between SILS Hysterectomy and LAVH

Number of Size of Number Length of Recovery
external external of visible hospital time
incisions incisions scars stay

SILS TM 1 small About 3/4 inch Potential for Same day 2 weeks
hysterectomy incision (slightly smaller no visible
(incision in the then the diameter scars
belly button) of a nickel)
Abdominal 1 large 5 to 7 inches 1 large scar 1 to 2 days 6 to 8 weeks
(open) incision sometimes 4
hysterectomy days
Laparoscopic 3 to 4 small From 1/4 to 3 to 4 small same day 2 weeks
hysterectomy incisions about 3/4 inch scars
Vaginal 0 to 4 0 to 3/4 inch 0 to 4 scars 1 to 3 days 3 to 4 weeks
hysterectomy/ incision
Laparoscopically
assisted vaginal
hysterectomy
(LAVH)

Future Prospects of SILS 2. Vecchio R, MacFayden BV, Palazzo F. History of laparoscopic
surgery. Panminerva Med 2000;42:87-90.
In the future, SILS will overcome some of the manipulative 3. Casillas RA, Yegiyants S, Collins C. Early laparoscopic
restriction of current instruments. But the future of any cholecystectomy is the preferred management of acute
new technology depends upon its acceptance by patient cholecystitis. Arch Surg 2008;143(6):533-37.
and surgeon. Its ease of application and training may show 4. Ghezzi F, Cromi A, Colombo G, Uccella S, Bergamini V, Serati
M, Bolis P. Minimizing ancillary ports size in gynecologic
the acceptance and some long-term randomized control trials laparoscopy: A randomized trial. J Minim Invasive Gynecol
21
are awaited to draw any conclusion. 2005;12:480-85.
5. Esposito C. One-trocar appendectomy in pediatric surgery. Surg
CONCLUSION Endosc 1998;12:177-78.
6. Kaouk JH, Haber GP, Goel RK, Desai MM, Aron M, Rackley
The concept of performing laparoscopic surgery via a single RR, Moore C, Gill IS. Single-port laparoscopic surgery in
incision regardless of the technique is gaining traction rapidly urology: Initial experience. Urology 2008;71:3-6.
among patients, surgeons, industry, and investors. It is likely 7. Piskun G, Rajpal S. Transumbilical laparoscopic
that the public will demand this even less invasive surgical cholecystectomy utilizes no incisions outside the umbilicus. J
Laparoendosc Adv Surg Tech A 1999;9:361-64.
approach much in the same way that it forced the explosion 8. Hurd WW, Bude RO, DeLancey JO, Newman JS. The location
of laparoscopic surgery two decades ago. Days are coming, of abdominal wall blood vessels in relationship to abdominal
so that more technological improvement in articulating landmarks apparent at laparoscopy. Am J Obstet Gynecol
instruments of SILS for better ergonomics will be there. 1994;171:642-46.
And there is no doubt that 5 years from now SILS will 9. Quint EH, Wang FL, Hurd WW. Laparoscopic transillumination
emerge as method of choice for laparoscopic hysterectomy. for the location of anterior abdominal wall blood vessels.
J Laparoendosc Surg 1996;6:167-69.
In our review, it has been found that SILS is becoming an 10. Michael R Cox, John L, McCall, James Tooli, Robrt TA
effective alternative to LAVH but further studies are required Padbury, Thomas G Wilson, David A. Wattchow, Mary
to confirm its efficacy. Langcake. Prospective randomised comparison of open versus
Laparoscopic appendectomy in Men;World J Surg 1996;20:
REFERENCES 263-66.
11. Tate JJT. Laparoscopic appendectomy. Br J Surg 1996;83:
1. Schollmeyer T, Soyinka AS, Schollmeyer M, et al. Georg Kelling 1169-70.
(1866-1945): The root of modern day minimal invasive surgery. 12. Anders Thorell, Staffan grondal, Kjell Schedvins, Goran Wallin.
A forgotten legend? Arch Gynecol Obstet 2007;276:505-09. Eur J Surg 1999;165:751-54.

World Journal of Laparoscopic Surgery, May-August 2010;3(2):67-74 73