Single Incision Laparoscopic Surgery (SILS) in Small Animals: A Systematic Review and Meta-Analysis of Current Veterinary Literature

Abstract

In veterinary surgery, single incision laparoscopic surgery (SILS) techniques have been described since 2009, and, in recent decades, many authors have reported the application of SILS in small animals, thus, promoting the wide dissemination of this novel approach among veterinary laparoscopists. The aim of this literature review is to provide a critical evaluation of the scientific reports on SILS in the field of small animal laparoscopic surgery. A comprehensive literature review was performed including from 1 January 2009 to 1 July 2020. The following data were recorded from each study: the design, year of publication, surgical procedure, species, number of animals included, and surgical time. The type of SILS technique and type of control group technique were evaluated. In total, 90 articles were identified through database searches and manual searches. The qualitative analysis showed that most of the articles were retrospective studies, without a control group or case series. A meta-analysis was performed on the eight controlled studies, showing that SILS ovariectomy and gastrointestinal procedures had a comparable surgical time to multiport techniques. The study of the articles available in the veterinary literature did not allow for an adequate meta-analysis of the published results, especially regarding post-operative pain, evaluations of surgical times, and post-operative complications in comparison to multiport techniques. Therefore, veterinary surgeons who want to employ these techniques must consider the real advantages of SILS techniques.

Two-Port Laparoscopic Adrenalectomy in Dogs

“…Single-incision laparoscopy surgery (SILS) is used in veterinary medicine for different surgical procedures [ 17 , 31 , 32 , 33 ]. Analyzing the data reported in the literature, the time consumed during laparoscopic surgery is evident, especially due to the loss of triangulation and instrument collisions [ 34 ]. The technique does not need organ retraction and allows for an excellent visualization of the adrenal gland.…”

Wound Retractor Laparoscopic Port System for Laparoscopic Ovariectomy in Panthera leo

“…Both of these techniques use three tools, which eliminates the need for transabdominal ovarian pedicle suspension to the abdominal wall, which is required when performing a two-cannula ovariectomy, as described for dogs and cats [19]. The use of a single portal, on the other hand, necessitates a distinct learning curve, a higher level of surgical abilities, and articulated tools because the tight trajectory of straight instruments causes shaft interference and the loss of triangulation [20].…”