Transumbilical Gelport Access Technique for Performing Single Incision Laparoscopic Surgery (SILS)

Emory Endosurgery Unit, Department of Surgery, Emory University, 1364 Clifton Road, Suite H-127, Atlanta, GA 30322, USA.
Journal of Gastrointestinal Surgery (Impact Factor: 2.39). 11/2008; 13(1):159-62. DOI: 10.1007/s11605-008-0737-y
Source: PubMed

ABSTRACT INTRODUCTION: Single incision laparoscopic surgery (SILS) is an area of active research within general surgery. DISCUSSION: A number of procedures, including cholecystectomy, appendectomy, urologic procedures, adrenalectomy, and bariatric procedures, are currently being performed with this methodology. There is, as yet, no standard published technique for single-port access to the peritoneal cavity for SILS. We describe, herein, an access technique utilizing existing instrumentation including a Gelport and wound retractor that is reliable and easy. This technique has been used successfully at our institution for a number of single incision laparoscopic procedures.

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    • "Although SILS practice is relatively new, it has already been applied in plenty of surgical procedures by keen on surgeons. Many procedures such as cholecystectomy, adrenalectomy, laparoscopic total extraperitoneal inguinal hernia repair, right hemicolectomy, left hemicolectomy, rectum operations, sleeve gastrectomy, gastrojejunostomy, and nephrectomy have been performed through single-incision and reported to the world literature [8] [9] [10] [11] [12] [13] [14] [15] [16] [17] [18]. Performing Nissen Fundoplication from a single incision through the umbilicus has perfect cosmetic results. "
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    ABSTRACT: Background. Single-incision laparoscopic surgery has recently became popular on behalf of inventing less invasive procedures. In this paper, we present a case of Pure SILS Nissen Fundoplication. Patient and Methods. In February 2010 a 29-year old male patient with a 4 cm sliding hiatus hernia presenting with reflux symptoms had undergone a standard floppy Nissen Fundoplication with a hiatus repair via single 2 cm incision in umbilicus. Results. The procedure had obeyed the standard natural orifice surgery rules, and no needlescopic assistance for any stage of the operation was used so to be a pure single-incision procedure. The operation lasted for 120 minutes without any need of conversion, and the patient was discharged the following day of operation. Conclusion. In the recent time, hybrid single incision laparoscopy techniques have been defined with the use of extra-abdominal supplements for retraction of liver or stomach for Nissen procedure. In addition the main issue in single-incision upper GI and/or hiatus surgery is still the retraction of liver. We succeeded to retract the left lobe of liver through the incision and completed the operation without any need for supplemental access besides the umbilical incision till the end. SILS Hiatus Surgery can be safely and effectively done but the issue needs further clinical studies to state the efficacy when compared to standard laparoscopy.
    07/2011; 2011:347487. DOI:10.5402/2011/347487
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    • "But due to the discussion about NOTES, another approach for the treatment of both genders is getting more attention from the public. The transumbilical access, described in the literature amongst others as laparoscopic single-site surgery (LESS) [5] [6]. For this technique, a 15 to 20 mm incision is made direct through the umbilicus , which is defined as a natural embryonic scare, and, therefore, the procedure is also called e-NOTES (embryonic natural orifice transumbilical endoscopic surgery). "
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    ABSTRACT: Background and Aims. We describe our experience of performing transumbilical single-incision laparoendoscopic cholecystectomy as standard procedure for acute and chronic gallbladder diseases. Methods. Between September 2008 and March 2010, 220 patients underwent laparoscopic single-incision surgery. A single port was used for 196 patients and two conventional 5 mm and one 10 mm port in 24 cases. All operations were performed with straight instruments. Results. Single-incision surgery was successfully performed in 215 patients (98%). Three patients (1.4%) required conversion to a three-port technique and two patients (0.9%) to an open procedure. Average age of 142 women (65%) and 78 men (35%) was 47 years (range: 15-89), average ASA status 2 (range: 1-3) and BMI 28 (range: 15-49). Mean operative time was 62 minutes (range: 26-174) and 57 patients (26%) had histopathological signs of acute cholecystitis. Eleven patients (5%) developed to surgery-related complications and nine (4%) of these required a reoperation. The mean followup was 331.5 (range: 11-590) days. Conclusion. Transumbilical single-incision cholecystectomy is a feasible and safe new approach for routine cholecystectomy. After a short learning curve, operation time and complication rate are comparable with standard multiport operation. In addition, most cases of acute cholecystitis can be performed with this technique.
    07/2011; 2011:915735. DOI:10.1155/2011/915735
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    ABSTRACT: L’appendicite è la più frequente causa di addome acuto nel bambino ed è responsabile di circa un terzo dei ricoveri per dolore addominale.
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