Single-Incision Laparoscopic Surgery Helps Patients Heal Faster

Replacing the traditional five incisions used for laparoscopic surgery with single-incision laparoscopic surgery (SILS) reduces future scarring and accelerates healing.

With SILS, surgeons make one single 8-centimeter incision instead of several through the abdominal wall; the surgeon operates through a single entry point, often a crease of skin or in the area of the umbilicus (belly button). SILS surgical procedures are like many other laparoscopic surgeries in that the patient is under general anesthesia, insufflated, and laparoscopic visualization is utilized; surgeons use a special camera to see around obstructions and special graspers with a curved tip. Developed at Drexel University (Philadelphia, PA, USA), SILS--also known as single port access (SPA)--uses a new class of laparoscopic instruments called high dexterity instruments, and has been used to perform various surgeries such as cholecystectomy, nephrectomy, appendectomy, hysterectomy, oopherectomy, adrenalectomy, and others. Since the entire surgery is usually performed around the belly button (umbilicus) area, it does not leave any visible scar like a traditional multi-port laparoscopic approach.

"There's a current revolution in minimally invasive surgery: Can we make laparoscopic surgery better by decreasing the number of incisions?” said Daniel Scott, M.D., an associate professor of surgery and director of the center for minimally invasive surgery at University of Texas Southwestern (UT Southwestern, Dallas, USA). "The theory behind this, not yet proven, is that fewer scars are better cosmetically and for pain control. The pain may be less because you alleviate additional cuts, and therefore the recovery may be hastened.”

"The SILS approach allows patients to have a better cosmetic result with minimal discomfort after surgery. Fewer incisions can mean a faster recovery, less risk for infection or later hernia, less risk for bleeding, and less pain,” said surgeon Christofer Senkowski, M.D., of the Memorial University Medical Center (MUMC, Savannah, GA, USA).

High dexterity (HD) instruments offer a full range of motion, and are designed to mirror the surgeon's hand direction with the added benefit of tactile feedback. As such, when the surgeon's hand moves in one direction, the instrument tip exactly follows. The best-known HD instruments are the award-winning RealHand instruments, developed and manufactured by Novare Surgical Systems (Cupertino, CA, USA), which offer a complete seven degrees of freedom of movement in a hand-held instrument, and without the need for additional hardware. The instruments are equipped with the proprietary EndoLink mechanism, which provides for greater dexterity and control around critical structures and vasculature by allowing wrist-like left/right and up/down movements inside the closed surgical field.


Related Links:
Drexel University
Novare Surgical Systems