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A Review Of Single Incision Laparoscopic Surgery

By Edward Thomas

Surgery is one of the fields in medicine that continues to evolve very rapidly. The advances that have been made in the field have made it possible to perform major operations with very few complications. Apart from restoring of function in diseased organs, many patients care about the cosmetic appearance of their skin as much as they want to function normally again. This is the main reason as to why minimally invasive techniques such as single incision laparoscopic surgery are replacing open surgeries in New York city.

As the name suggests, this is minimally invasive type of surgery in which a single port of entry is used. This entry point is in most cases the navel of the patient. Like many other types of surgeries, this operation is done under general anesthesia. It is also known as single port laparoscopy (SPL) or single port access surgery (SPA). The traditional laparoscopic technique requires three separate incisions to be made.

The technique is used for a wide range of conditions. These include gall bladder removal (cholesystectomy), removal of the appendix, repair of hernias and in pelvic surgeries such as the removal of the uterus and the ovary. As it continues to gain acceptance in the community of surgeons, this list is bound to increase even further.

There are a number of advantages that are associated with this procedure. One of them is the fact that recovery is faster and many patients can resume their routine duties in a few days. It is also cosmetically superior to the other methods due to the fact that only one incision is used. The main disadvantage is that it is a little more expensive than the other methods due to the high level of specialization needed.

There is significant technical challenge is the surgeon is not experienced enough with the technique. Challenges mainly arise from the difficulty of maneuvering the instruments in the same opening. The crowding caused by these instruments makes it difficult to the field clearly. Taking this into account, the risk of intraoperative injury is actually higher in less experienced hands as compared to other methods.

The option is not suitable for persons that are very obese, those with a history of other operations and those with a grossly enlarged abdominal organ. In the event that it is not possible to complete the operation using the single incision, an additional port will be created to proceed with the traditional approach. This happens in 5% to 10% of cases. The open technique may be required in rare circumstances.

In spite of the huge success that is attributable to this type of operation, there are some risks that one should be aware of before signing up for it. Bleeding and infections are the most commonly encounter. However, fewer cases are seen as compared to those associated with open surgery and ordinary laparoscopic operations. Incisional hernias that are fairly common with the open technique are a rare occurrence.

This surgical technique has a wide range of applications. It is set to be the main technique in the management of pediatric and gynecological surgical problems. Many training institutions have now incorporated the practice into their curricula and plan to retrain specialist surgeons and residents.

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