Merchant AM, Cook MW, White BC, Davis SS, Sweeney JF, Lin E. 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: 2.8).
11/2008; 13(1):159-62. DOI: 10.1007/s11605-008-0737-y
Single incision laparoscopic surgery (SILS) is an area of active research within general surgery.
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.
Available from: Antonia Rizzuto
- "The evolution of surgery toward less invasive approaches brought about a new technique known by the acronym SILS (single incision laparoscopic surgery)  . The surgeon makes a single incision in the navel (belly button) (about 20 mm) as the access port to the abdominal cavity. "
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ABSTRACT: In the last ten years, the single incision laparoscopic surgery (SILS) is gaining more interest than the traditional laparoscopic surgery (LAP). Many studies make a comparison between the performances of the SILS and the LAP. The results show that the single incision laparoscopic surgery reduces pain, length of period of postoperative hospitalization, and loss of blood. This technique is also able to reduce the infection sites. In spite of many advantages, SILS reveals some problems: laparoscopic instruments triangulation and small workspace. The surgeon has to be more skillful to make a surgery in SILS because the surgeon has only three laparoscopic instruments and only one hole in the abdomen cavity. In this paper, a novel laparoscopic instrument to help the surgeon during a SILS operation is presented. This instrument is innovative forceps with double graspers. Different designs of this instrument are presented, with the final one which greatly simplifies both construction and operation. The initial experience in the laboratory with the innovative instrument is presented. The surgeon experienced in laparoscopic surgery and with the help of assistants performed a training program based on predetermined task performed in simulation box (laparoscopic box-trainer).
Available from: Husnu Alptekin
- "The single incision laparoscopic cholecystectomy (SILC) was first described in 1997 as involving two incisions done in the periumbilical region 4. Specific hand tools and ports are not needed in many single incision laparoscopic cholecystectomies. The literature provides various definitions such as SILS (single incision laparoscopic surgery), single-port access, single laparoscopic incision transabdominal surgery, dual incision laparoscopic technique, and single incision multiport laparoscopic cholecystectomy 5-6. "
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ABSTRACT: Purpose: Single incision laparoscopic surgery in suitable cases is preferred today because it results in less postoperative pain, a more rapid recovery period, more comfort, and a better cosmetic appearance from smaller incisions. This study aims to present our experiences with single incision laparoscopic cholecystectomy to evaluate the safety and feasibility of this procedure.
Methods: A total of 150 patients who underwent single incision laparoscopic cholecystectomy between January 2009 and December 2011 were evaluated retrospectively. In this serial, two different access techniques were used for single incision laparoscopy.
Results: Single incision laparoscopic cholecystectomy was performed successfully on 150 patients. Median operative time was 29 (minimum-maximum=5-66) minutes. Median duration of hospital stay was found to be 1.33 (minimum-maximum=1-8) days. Patients were controlled on the seventh postoperative day. Bilier complication was not seen in the early period. Five patients showed port site hernia complications. Other major complications were not seen in the 36-month follow-up period.
Conclusion: Operation time of single incision laparoscopic cholecystectomy is significantly shortened with the learning curve. Single incision laparoscopic cholecystectomy seems a safe method.
- "In seven others, it was explicitly stated that the selected patients had a BMI of 35 kg/m or less.[10–17] In five studies, no clear inclusion criteria were mentioned.[18–22] "
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ABSTRACT: The aim of this study was to establish the incidence of postoperative complications after single incision laparoscopic cholecystectomy.
A literature search was performed using the PubMed database. Search terms included single incision laparoscopic cholecystectomy, single port cholecystectomy, minimal invasive laparoscopic cholecystectomy, nearly scarless cholecystectomy and complications.
A total of 38 articles meeting the selection criteria were reviewed. A total of 1180 patients were selected to undergo single incision laparoscopic cholecystectomy. Introduction of extra ports was necessary in 4% of the patients. Conversion to open cholecystectomy was required in 0.4% of the patients. Laparoscopic cholangiography was attempted in 4% of the patients. The incidence of major complications requiring surgical intervention or ERCP with stenting was 1.7%. The mortality rate was zero.
Although the number of complications after single incision laparoscopic cholecystectomy seems favourable, it is too early to conclude that single incision laparoscopic cholecystectomy is a safe procedure. Large randomised controlled trials will be necessary to further establish its safety.
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