By Margaret Bailey


Advancements in technology are leading to the invention of better and new approaches to surgical procedures in all fields of medicine. Single incision laparoscopic surgery, often abbreviated as SILS also goes by several other names. Some of those names include Single-port laparoscopy (SPL), single-port incisionlless conventional equipment-using surgery, single-port access surgery (SPA), and Single-access endoscopic surgery. Additional names are natural-orifice trannsumbilical surgery (NOTUS), laparo-endoscopic singular-site surgery (LESS), and one-port umbilical surgery (OPUS).

SILS as a technique under laparoscopic surgery is still a relatively new idea with a rather short history. It falls under minimally invasive techniques of surgical operations because of its use of one incision point. In many patients, the navel serves as the entry point. Small scars are formed from the process. The small size of the scar is among the reasons for high preference of the method by patients and surgeons.

The entry point can be made into a 20 mm or 11mm incision. The importance of utilizing only a single entry point is to minimize pain and scarring. This is opposed to traditional laparoscopic surgical procedure in which multiple entry point are made and used. New York is home to some of the most well-trained and qualified specialists in this kind of procedure. Thus it would be a great place to consider visiting if one needs such a process done to them.

The process makes use of specialized surgical equipment that can be classified into two major classes, that is hand and access ports instruments. There is a wide variety of access ports instruments including the GelPOINT system, SILS device, TriPort+, QuadPort+, TriPort15, and Uni-X. All these instruments are manufactured by different manufacturers.

Conversely, three major configurations of hand instruments exist today. They are pre-bent rigid, standard, and articulating configurations. The development of standard hand tools has been happening for more than the previous 30 years. Rigid design is used in making them. SPL reduced triangulation instrument challenge has been solved through the invetion of articulation hand instruments.

A choice always has to be made between standard and articulating instruments by surgeons. Certain factors play a role in influencing that decision. Among those factors are cost, access port utilized, the level of training and skills commanded by the surgeon. It costs much more to use articulating instruments compared to using standard ones. However, the use of specialized tools promotes safety and efficiency.

The degree of awareness of SILS among surgeons is very high. However, the performance of SILS is limited to a few surgeons owing to its high level of complexity, limited space of access, and the use of specialized instruments. Surgical doctors who perform the procedure have to be highly skills and trained in surgical processes. That has promoted negative perception from the public and limited indulgence in the process.

SILS can be applied in performing a wide range of surgeries. Some of the most the include colectomy, sleeve gastrectomy, hysterectomy, appendectomy, nephrectomy, adjustable gastric banding, and sacrocolpopexy among many others. In the United States, standard instruments dominate this field of surgical operation as opposed to specialized instruments.




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