Single-incision laparoscopic surgery: An overview

Udwadia, Tehemton E.

doi:10.4103/0972-9941.72354

Cited by 17 publications

(20 citation statements)

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“…Most importantly, it is easy to convert SILS to conventional laparoscopy by adding a few trocars, this conversion to conventional laparoscopy being called ‘port rescue’. [19] It has also been shown to be feasible, reasonably safe and cosmetically advantageous to standard laparoscopy. [1920] However, this newer technique involves specialized instruments and has a steep learning curve due to a loss of triangulation, clashing of instruments, crossing of instruments (cross triangulation), and a lack of maneuverability.…”

Section: Discussionmentioning

confidence: 99%

“…[19] It has also been shown to be feasible, reasonably safe and cosmetically advantageous to standard laparoscopy. [1920] However, this newer technique involves specialized instruments and has a steep learning curve due to a loss of triangulation, clashing of instruments, crossing of instruments (cross triangulation), and a lack of maneuverability. [1920] There is also the additional problem of decreased exposure and an added financial burden of procuring special articulating or curved coaxial instruments.…”

Section: Discussionmentioning

confidence: 99%

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Two-port vs. three-port laparoscopic appendicectomy: A bridge to least invasive surgery

et al. 2012

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INTRODUCTION:The conventional three-port technique for laparoscopic appendicectomy has proven its worth in the management of appendicular pathologies. From a cosmetic viewpoint, the umbilical and suprapubic port-sites are hidden by natural camouflages, the right Iliac fossa (RIF) port is the only visible external sign of surgery. The two-port technique avoids even this marker of abdominal invasion. In this study, we describe the technique of two-port laparoscopic appendicectomy (TPA) and compare it with conventional laparoscopic appendicectomy (CLA).MATERIALS AND METHODS:All patients studied underwent operation for acute appendicitis during a 6-month period. Data were collected prospectively for the TPA and retrospectively for the CLA. The TPA was performed with one 10 mm umbilical working port and one 5 mm suprapubic camera port. A hypodermic needle was introduced in the RIF to retract the appendix. The appendicular artery was controlled with diathermy or ultrasonic shears. The base was ligated with a loop knotted extracorporeally. CLA was performed via the conventional 10 mm umbilical, 5 mm suprapubic and 5 mm RIF ports. The appendicular stump was ligated with an endoloop or an intracorporeal knot.RESULTS:A total of 146 patients underwent surgery over the 6-month period for appendicitis. Out of 62 cases attempted, the TPA was successful in 51 cases, with conversion to the three-port technique in 11. The operative time, complication rates, return to work were comparable between the two groups. Patients who had TPA had a shorter postoperative stay.CONCLUSION:This is an initial experience with TPA. There is little difference in the operative time, postoperative stay and complications rates between this technique and the conventional three-port one. There is hence little to be lost and a likely benefit to be gained by performing the TPA although a randomised study is necessary.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Two-port vs. three-port laparoscopic appendicectomy: A bridge to least invasive surgery

et al. 2012

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“…19,20 However, this newer technique involves specialized instruments and has a steep learning curve due to a loss of triangulation, clashing of instruments, crossing of instruments (cross triangulation), and a lack of maneuverability. 19,20 There is also the additional problem of decreased exposure and an added financial burden of procuring special articulating or curved coaxial instruments. 20 SILS is still evolving, being used successfully in many a center, but with a significant way to go before it becomes mainstream.…”

Section: Discussionmentioning

confidence: 99%

Two-port vs. conventional (three-port) laparoscopic appendicectomy: a new technique in laparoscopic appendicectomy

2015

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Background: Three-port laparoscopic appendicectomy has proven its worth in the management of appendicitis. From a cosmesis, the umbilical and suprapubic portsites are hidden by natural camouflages, the Right Iliac Fossa (RIF) port is the only visible external sign of surgery. The two-port technique avoids even this marker of abdominal invasion. Methods: 58 patients were studied for this study. Data was collected prospectively. The two port appendicectomy was performed with 10 mm umbilical working port and 5 mm supra-pubic camera port. A stitch was taken transparietaly in RIF which was under camera guidance passed through the tip of appendix and held with suture to retract the appendix. The base was ligated with an intra-corporeal knot and appendix cut and delivered out. Three port appendicectomy was performed via the 10 mm umbilical, 5 mm supra-pubic and 5mm right iliac fossa ports. The appendicular stump was ligated with an endoloop or an intra-corporeal knot, appendix cut and delivered outResults: 58 patients underwent surgery over the one year period for appendicitis. Out of 26 cases attempted, the two port appendicectomy was successful in 21 cases, with conversion to the three-port technique in 4 and conversion to open in 1 case. The complication rates, return to work were comparable between the two groups. Duration of operation was more whereas length of hospital stay was less in two port appendicectomy group as compared to conventional laparoscopic group.Conclusions: Patients who underwent two port appendicectomy had a cosmetically better appearing scar than compared to three port appendicectomy cases.

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“…The only drawback is that it is difficult if there are dense adhesions or long retrocolic appendix. In such cases it can easily converted to CLA by placing an additional trocar in the right iliac fossa -"port rescue" 4 . TLA can be considered as best procedure for selective cases of AA.…”

Section: Discussionmentioning

confidence: 99%

“…No doubt single incision laparoscopic Surgery (SILS) can be done with special multiport umbilical trocar and specialized instruments but has a steep learning curve due to loss of triangulation, clashing of instruments, lack of maneuverability, decreased technical expertise among the surgeons and an added financial burden to the patients, thus limiting its widespread use especially in rural/peripheral centers with limited resource. 4,5 Recent development is natural orifice trans-luminal endoscopic surgery (NOTES). But, there are numerous difficulties including, complications of opening hollow viscera, failed sutures, lack of fully developed instrumentation and necessity of reliable cost-benefit analyses.…”

Section: Introductionmentioning

confidence: 99%