Page 41 - WJOLS - World Journal of Laparoscopic Surgery

REVIEW ARTICLE
Single-port Laparoscopic Surgery: A Mini Review

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Reno Rudiman , Andika A Winata 2

AbstrAct
Introduction: Operative laparoscopy has advanced progressively since 1987 after laparoscopic cholecystectomy by means of four trocars. One
of the main advantages of laparoscopic surgery over traditional open surgery is that it often requires a shorter hospital stay than traditional
open surgery. Compared to conventional laparoscopic surgery, single incision laparoscopic surgery (SILS) has more benefits. In this article, we
review laparoscopic surgery with single incision.
Materials and methods: Literature review was performed on newly minimal invasive approach for laparoscopic surgery.
Results: Single incision laparoscopic surgery has advantages in minimizing the invasiveness of surgical incision, reducing the number of
incisions and the associated possible wound morbidities. This includes the reduced risks of wound infection, pain, bleeding, organ injury, and
port site hernia. Even though SILS is recognized to be a more complicated procedure and costly, patients are experiencing less pain and almost
scarless wound.
Conclusion: Single incision laparoscopic surgery is an exciting new approach in the field of laparoscopic surgery.
Keywords: Laparoscopic surgery, SILS, Single port.
World Journal of Laparoscopic Surgery (2018): 10.5005/jp-journals-10033-1356

IntroductIon 1,2 Department of Digestive Surgery, Padjadjaran University, Bandung,
Surgery to treat various diseases has been recorded back to the West Java, Indonesia
middle ages. For two centuries, large incisions were necessary Corresponding Author: Reno Rudiman, Department of Digestive
to perform abdominal surgical procedures. Although effective, Surgery, Padjadjaran University, Bandung, West Java, Indonesia,
several known morbidities were related to this method, including Phone: +62 81310008995, e-mail: andhika.august@gmail.com
postoperative pain, wound infection, incisional hernia, and How to cite this article: Rudiman R, Winata AA. Single-port Laparoscopic
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prolonged hospitalization. The present surgical site infection rate Surgery: A Mini Review. World J Lap Surg 2018;11(3):149–150.
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is 15–25%, depending on the level of contamination. Source of support: Nil

Laparoscopic surgery was introduced in 1983 by Lukichev and Conflict of interest: None

1985 by Muhe who performed laparoscopic cholecystectomy.
Their cumbersome techniques did not receive the attention they
probably deserved. Interest started to grow after Mouret in 1987 to most patients. Risks of keloid formation is therefore significantly
reported the first acknowledged laparoscopic cholecystectomy reduced as well.
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by means of four trocars. Since then, operative laparoscopy has In conventional laparoscopic surgery, 3–4 small incisions
advanced progressively. Several operative procedures have been are made. In a more complex procedure such as large bowel
performed by this new approach. Due to its minimal invasiveness resection or bariatric (obesity) surgery, up to six incisions can
to the abdominal wall, laparoscopic surgery is also called minimally be made, allowing more instruments to be used to assist organ
invasive surgery. Laparoscopic procedures can be performed using resection. Obviously, the more the wounds made, the more
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small incisions of around 0.5–1.5 cm that can be made far away from pain it will eventually cause to the patients. On the contrary, less
the surgical site. Small surgical instruments can then be inserted wound signifies less pain. This brings about the concept of Single
through the incision and passed through to the operational site. incision laparoscopic surgery (SILS).
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The whole procedure is performed using a laparoscope, which is Single incision laparoscopic surgery has many other names,
a camera instrument that can relay live video images from inside including laparo-endoscopic single-site surgery, single-port access
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the body to a TV monitor. surgery, trans-umbilical endoscopic surgery, and one-port umbilical
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surgery. There is no standardized name so far.
LIterAture revIew With this technique, the surgeon operates exclusively through
One of the main advantages of laparoscopic surgery over traditional a single entry point, typically at the patient’s umbilicus. Unlike a
open surgery is that it often requires a shorter hospital stay than traditional multiport laparoscopic approach, SILS leaves only a single
traditional open surgery. Procedures such as appendectomy or small scar. During the years following the introduction of SILS in 1997,
cholecystectomy require the patient to stay at the hospital for only enthusiasm was limited because of lack of technical support and
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one night after surgery. This is because patients experience less poor equipment. In 2005, Hirano et al. reintroduced the technique
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pain and bleeding after surgery. with some advancements compared to previous techniques. Since
Another important advantage of laparoscopic surgery is that as then, the technology has progressed steadily. Among advancements
the incision wound is much smaller than open surgery, post-surgical created were articulating instruments, laparoscope adjustments,
scarring is significantly reduced. Cosmetically, it is more desirable several trocars adjacent to each other through a single incision.
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