dimanche 24 janvier 2016

Basics 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.

As the name suggests, this is minimally invasive type of surgery in which a single port of entry is used. This entry point is in most cases the navel of the patient. Like many other types of surgeries, this operation is done under general anesthesia. It is also known as single port laparoscopy (SPL) or single port access surgery (SPA). The traditional laparoscopic technique requires three separate incisions to be made.

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.

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 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.

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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