Wednesday, January 20, 2016

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.

Laparoscopic operations have traditionally required three entry ports made in the anterior abdominal wall to facilitate the entry of the laparoscope and the instruments. For single incision surgery, only one of these ports is required for both the laparoscope and the instruments. For this reason, the operation is also known as single port access surgery (SPA) or single port Laparoscopy (SPL).

There are a number of surgical operations that can be performed using this technique. They include gallbladder removal, repair of inguinal and incisional hernias, appendectomy and the removal of pelvic organs such as the ovary and the uterus among others. This list continues to grow by the day as better instruments are invented to make it easier to perform such operations.

There are a number of benefits that are associated with using this technique. One of them is the fact that the recovery time is shorter. Most of the people that have been operated on can return to work in a week. With only one incision, the cosmetic results are a lot better than with conventional laparoscopic operations. The main disadvantage on the patient is that they may have to pay a little more mainly due to the high level of specialization.

It is important to mention that using the technique is a lot more cumbersome than the traditional methods. Using the same opening for all the instruments may not be that easy for surgeons who are not adequately experienced. This is because instrument crowding obscures the view and the distance from the incision site to the target site is often longer. As a result, the risk of intraoperative injury is higher than in other methods without proper training.

This technique is not suitable for use in patients that are very obese, those that have a massively enlarged abdominal organ and those with a history of multiple operations. This is because of the difficulties that are associated with operating these groups of patients. In case, the operation cannot be completed successfully (as happens in 5 to 10% of cases). Additional ports can be created or even conversion to the open procedure in rare cases.

There are risks that you need to be aware of even as you consider undergoing the operation. Bleeding and surgical site infections are the most frequently encountered but their incidence is far less than what is seen with the other methods. Incisional hernias are a common problem with open surgery but with this technique they 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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