Wednesday, February 10, 2016

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 surgeries use three to five openings that are much smaller than the incision used for open surgeries. In single incision surgery only one is required. General anesthesia is usually required just as is the case with many other operations. Other terms used to describe the technique include single port laparoscopy, SPL, and single port access surgery, SPA.

The technique is used for a wide range of conditions. These include gall bladder removal (cholesystectomy), removal of the appendix, repair of hernias and in pelvic surgeries such as the removal of the uterus and the ovary. As it continues to gain acceptance in the community of surgeons, this list is bound to increase even further.

There are a number of advantages that are associated with this procedure. One of them is the fact that recovery is faster and many patients can resume their routine duties in a few days. It is also cosmetically superior to the other methods due to the fact that only one incision is used. The main disadvantage is that it is a little more expensive than the other methods due to the high level of specialization needed.

It is important to mention that using the technique is a lot more cumbersome than the traditional methods. Using the same opening for all the instruments may not be that easy for surgeons who are not adequately experienced. This is because instrument crowding obscures the view and the distance from the incision site to the target site is often longer. As a result, the risk of intraoperative injury is higher than in other methods without proper training.

The technique is a bit difficult to execute in persons that are very obese. The same challenges may be encountered in persons who have an organ that is massively enlarged or those that have undergone other abdominal surgeries in the past. At times, it is not possible to complete the operation using the single incision. Whenever that happens more ports are created or a conventional (longer) incision made.

Just as is the case with any surgical operation, risks exist. Bleeding and infections are the most common but their incidence is a lot lower than what is seen with other techniques. Incisional hernias, a common complications of open operations, is a very rare occurrence.

This surgical technique has a wide range of applications. It is set to be the main technique in the management of pediatric and gynecological surgical problems. Many training institutions have now incorporated the practice into their curricula and plan to retrain specialist surgeons and residents.




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