Single Incision Surgery

Minimally invasive surgery (MIS) or laparoscopic surgery has offered the patients many benefits including, but not limited to, early recovery, less postoperative pain, cosmetic incisions and less incidence to incisional hernias.  Since the first laparoscopic cholecystectomy in 1985, laparoscopic surgery has expanded in leaps and bounds to become the standard procedure for many intra-abdominal surgeries. With traditional laparoscopy and multi-port da Vinci Robotic Surgery, surgeons operate through a few small incisions.

The quest for scar reduction beyond standard laparoscopy led to the experimentation with natural orifice surgery and single scar (incision) surgery. Single-port (incision) laparoscopy is not new. It had been around for more than 30 years. The gynaecologists were doing tubal ligation with a single-puncture laparoscope since the late 70s. This technique works well for gynaecological surgery as the uterus can be manipulated from below. These early instruments had offset eyepieces with a straight operating channel through which an applicator for the silicone ring to occlude the tubes, could be passed.

Single-incision laparoscopic surgery is a very exciting modality in the field of minimal access surgery which works for further reducing the scars of standard laparoscopy and towards scarless surgery. This kind of technique has been very appealing to patients who worry about the presence of scars in their bodies. With single incision traditional laparoscopy and da Vinci Single-Site Surgery, the surgeon operates through one small hidden incision in the navel (belly button).

If you have severe gallbladder symptoms, your doctor may recommend surgery to remove your gallbladder. It’s an organ you can live without. Gallbladder removal is known as a cholecystectomy. It can be performed using open surgery through a large incision or with minimally invasive surgery (laparoscopy).

Appendicectomies (removal of the appendix) have been done with a single puncture as early as 1992.  More recently this has even been described with transumbilical flexible endoscopy.[29] The use of multiple trocars rapidly gained popularity over the disadvantages of a single puncture. As conventional laparoscopy became popular even for complex procedures in surgery, it was usually carried out through four or more ports.

Increasing the number of ports led to reduced cosmesis, more pain and increased risk of complications due to port site infections and hernias. One advantage of reducing the number of ports over cosmesis, would be to reduce these complications.

The minimal access surgical techniques have come a full circle with the single-incision surgery gaining popularity once again.

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