Recent advances of robotic surgery and single port laparoscopy in gynecologic oncology

Abstract

Two innovative approaches in minimally invasive surgery that have been introduced recently are the da Vinci robotic platform and single port laparoscopic surgery (SPLS). Robotic surgery has many advantages such as 3-dimensional view, the wrist like motion of the robotic arm and ergonomically comfortable position for the surgeon. Numerous literatures have demonstrated the feasibility of robotic surgery in gynecologic oncology. However, further research should be performed to demonstrate the superiority of robotic surgery compared to conventional laparoscopy. Additionally, cost reduction of robotic surgery is needed to adopt robotic surgery into gynecologic oncology worldwide. SPLS has several possible benefits including reduced operative complications, reduced postoperative pain, and better cosmetic results compared to conventional laparoscopy. Although several authors have indicated that SPLS is a feasible approach for gynecologic surgery, there have been few reports demonstrating the potential advantages over conventional laparoscopy. Moreover, technical difficulties of SPLS still exist. Therefore, the advantages of a single port approach compared to conventional laparoscope should be evaluated with comparative study, and further technologic development for SPLS is also needed. These two progressive technologies take the lead in the development of MIS and further studies should be performed to evaluate the benefits of robot surgery and SPLS.

Single port transumbilical laparoscopic surgery for adnexal lesions: a single center experience in Korea

“…SPLS is a cutting-edge technology for minimally invasive surgery [12]. Although the single port laparoscopic approach has been used for tubal ligation since the 1970s and Ghezzi et al reported a successful salpingectomy using SPLS, the single port laparoscopic approach has not been widely used due to its technical difficulty [1,13].…”

Improvised Transumbilical Glove Port: A Cost Effective Method for Single Port Laparoscopic Surgery

“…Homemade transumbilical port using Alexis wound Retractor®, glove and conventional laparoscopic trocars have been in use to perform various operations like varicocelectomy, transumbilical pre-peritoneal (TAPP) inguinal hernia repair, hemicolectomy and laparoscopic total hysterectomy [1][2][3].…”

“…It can also be performed using one of the many commercially available multichannel single-port devices: R-port™ (Advanced surgical concepts, Dublin, Ireland), Uni-X™ (Pnavel system, Morganville, NJ, USA), and SILS port™ (Covedien). Several successful general surgical, urological and gynaecologica procedures were also performed with a homemade transumbilical port using the Alexis wound retractor® and surgical gloves [1][2][3]. The commercially available multichannel single-port devices are very costly and Alexis wound retractor® is not available in this part of our country.…”

Single-port laparoscopic surgery is applicable to most gynecologic surgery: a single surgeon’s experience

“…Recently, some reports have demonstrated the feasibility and safety of SPLS and the improvement in outcomes over conventional laparoscopy in terms of pain, recovery time, cosmesis, and duration of hospital stay [5][6][7][8][9][10]. However, SPLS is not widely available due to the technical difficulty of the procedure.…”