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Facts Relating To Single Incision Laparoscopic Surgery

By Edward Thomas


Surgery has evolved in a great way in the last few decades. Unlike in the past, when the main objective was to restore functionality, cosmesis appear to carry a lot of significance these days. In Ne York city for example, patients are increasingly requesting for smaller incisions so as to reduce the sizes of scars. This is perhaps what gave rise to laparoscopic surgery and most recently, single incision laparoscopic surgery. In this article we explore what exactly this operation is and what its benefits and downsides are.

Laparoscopic operations have traditionally required three entry ports made in the anterior abdominal wall to facilitate the entry of the laparoscope and the instruments. For single incision surgery, only one of these ports is required for both the laparoscope and the instruments. For this reason, the operation is also known as single port access surgery (SPA) or single port Laparoscopy (SPL).

This operating technique is used for many different conditions. These include, among others, gall bladder removal, appendectomy, hernia repair, pelvic operations such as the removal of the ovary and the uterus. This list is set to increase even further as many surgeons make the switch to the new approach.

One of the advantages is that there is less pain as compared to the traditional approach of laparoscopy. As a result, the patients tend to heal a lot faster. It also yields better results cosmetically bearing in mind that only a small opening is made. The main undoing would be the fact that it is marginally expensive than the traditional methods primarily due to the specialized equipment that is used.

There is significant technical challenge is the surgeon is not experienced enough with the technique. Challenges mainly arise from the difficulty of maneuvering the instruments in the same opening. The crowding caused by these instruments makes it difficult to the field clearly. Taking this into account, the risk of intraoperative injury is actually higher in less experienced hands as compared to other methods.

The option is not suitable for persons that are very obese, those with a history of other operations and those with a grossly enlarged abdominal organ. In the event that it is not possible to complete the operation using the single incision, an additional port will be created to proceed with the traditional approach. This happens in 5% to 10% of cases. The open technique may be required in rare circumstances.

In spite of the huge success that is attributable to this type of operation, there are some risks that one should be aware of before signing up for it. Bleeding and infections are the most commonly encounter. However, fewer cases are seen as compared to those associated with open surgery and ordinary laparoscopic operations. Incisional hernias that are fairly common with the open technique are a rare occurrence.

Single incision surgery is fast becoming one of the most popular techniques among patients and surgeons. This is mainly due to its minimal invasive nature that results in better cosmetic results. The risks involved are also reduced markedly. The fields of gynecology and pediatrics appear to be on the forefront in embracing this specialized procedure.




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