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Basics Of Single Incision Laparoscopic Surgery

By Margaret Bailey


Approaches to surgical operation are changing and evolving mostly because of major technological advancements that are being made in various fields including surgical medicine. Single incision laparoscopic surgery is often referred to using the abbreviation SILS, but it also has many other names. Among the names SILS goes by are Single-port laparoscopy, single-port access surgery (SPA), Single-access endoscopic surgery (SAES), and single-port incisionnless conventional equipment-using surgery (SPICES). Other names include natural-orifice trannsumbilical surgery (NOTUS), one-port umbilical surgery (OPUS), and laparo-endoscopic singular-site surgery (LESS).

SILS is a technique in laparoscopic surgery that is still relatively new owing to its recent development. It is classified as a minimally invasive surgical operation because most of the process is done through one entry point. In most cases, the navel serves as the entry point into interior of the patient. Thus, because only one entry point is used, only a single tiny scar is left behind after the process has been completed.

Entry points are either 11mm or 22 mm incisions. One incision is utilized to minimize scarring and pain felt during and after the process. The use of one incision is opposed to the traditional laparoscopic procedure that uses multiple entry points. There are some of the most highly qualified specialists in SILS in New York. Therefore, it is quite advisable to consider visiting the city when in search of specialists in this process.

Specialized surgical instruments in use by SILS fall into two wide categories. These wide categories are access ports instruments and hand instruments. Some of the access ports instruments are TriPort15, the Uni-X, SILS gadgets, TriPort+, GelPOINT system, and QuadPort+. The devices are designed and made by different companies.

Conversely, there are three key configurations of hand instruments in use. They include articulating, pre-bent rigid, and standard configurations. It has taken over the past thirty years to develop standard hand tools. They are made with rigid design. The SPL reduced triangulation instrument problem was solved by the development of articulation hand instruments.

The choice of whether or not to use articulating or standard instruments usually lies with the surgeons. There are a few factors that influence the decision. Among these influential factors are access port used, cost, and surgical skills of a surgeon. Articulating instruments are very costly when compared to standard instruments. This procedure is made safer and more effective by the use of specialized instruments.

The awareness of SILS among surgical practitioners is at a high level. Despite that fact, the application of SILS is restricted to a small number of surgeons. This is because it is complex, uses specialized instruments, and the space of access is limited. It takes a high level of training and skills to be able to perform the process. That plus many other factors have limited the number of people who engage in the process and it has also promoted a negative outlook from the public.

SILS has been used on a wide variety of surgical procedures. Some major examples include colectomy, sleeve gastrectomy, adjustable gastric banding, sacrocolpopexy, hysterectomy, appendectomy, and nephrectomy among several others. Among European countries and the United States, standard instruments are being used more commonly compared to specialized instruments.




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