Abstract
Background: Single incision laparoscopic surgery (SILS) has still not replaced conventional laparoscopic surgery in many centers because of its special instruments requirements and training needs. In our Institution we introduced SILS procedures in a procedural stepwise manner, with progression to more difficult procedures only allowed if complete proficiency in low-complexity ones is achieved. Methods: We studied the evolution of performed SILS procedures in our Institution from the beginning of the program (mainly appendectomies, cholecystectomies, left adrenalectomies) and the results from these techniques. Results: Among 328 SILS procedures there were 148 appendectomies (24 by suprapubic access), 141 cholecystectomies, 32 left adrenalectomies, 6 diagnostic laparoscopies and 1 resection of Meckel’s diverticulum. The majority of appendectomies accounted for non-perforated appendicitis cases and there were no significant differences between transumbilical and suprapubic access groups. In cholecystectomies the majority of patients were elective cases and oral intake could be resumed within the 6 postoperative hours. In left adrenalectomies no conversion to open surgery was required and there were no intraoperative or postoperative complications. Conclusions: Procedural stepwise approach in SILS is a valid, feasible and safe option that can be applied at any institution starting a SILS program.
Highlights
Laparoscopic surgery has experienced a fast development because of its advantages when compared to tradi-How to cite this paper: Martí, J., et al (2015) Single Incision Laparoscopic Surgery Development at the Hospital Clinic: Our 4-Year Experience
There were no significant differences between transumbilical and suprapubic access groups for the majority of study variables (Table 1)
Single incision laparoscopic surgery (SILS) has emerged as the logical evolving procedure from conventional laparoscopic surgery mainly because it decreases the amount of parietal injury to a minimal unique incision
Summary
Laparoscopic surgery has experienced a fast development because of its advantages when compared to tradi-How to cite this paper: Martí, J., et al (2015) Single Incision Laparoscopic Surgery Development at the Hospital Clinic: Our 4-Year Experience. SILS has still not replaced conventional laparoscopic surgery in many centers because of its special instruments requirements and training needs [8]. The majority of authors have started performing SILS procedures using specific articulated instruments and they have based their skills acquisition on the simultaneous performance of many different procedures [11]. This strategy needs large amounts of patients for procedural establishment purposes and can be rather difficult to apply in small centers where SILS is to be introduced. Conclusions: Procedural stepwise approach in SILS is a valid, feasible and safe option that can be applied at any institution starting a SILS program
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