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Özkurt E, Barbaros U, Aksakal N, Doğan S, Bozbora A. Single incision laparoscopic abdominal surgeries: case series of 155 various procedures, an observational cohort study. Turk J Surg 2020; 36:353-358. [PMID: 33778394 DOI: 10.47717/turkjsurg.2020.4795] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Accepted: 08/12/2020] [Indexed: 11/23/2022]
Abstract
Objectives Over the last decade, surgeons have started to think of the ways in which to further reduce the trauma of surgery and improve cosmesis. Consequently, many surgeons have yielded to single incision laparoscopic surgeries (SILS) in order to maximize operative and postoperative outcomes. This study aimed to highlight the feasibility and challenges of different procedures by presenting our data about different fields of abdominal SILS practices with long term follow-up. Material and Methods We retrospectively analysed an observational cohort of 155 patients who underwent surgery for different indications using the SILS technique. Results Of the 155 SILS procedures: 75 (48.4%) were cholecystectomies; 22 (14.2%) were splenectomies; 17 (11%) were hernia repairs; 11 (7.1%) were appendectomies; 8 (5.2%) were partial colon resections; 8 (5.2%) were adrenalectomies; 6 (3.8%) were distal pancreatectomy & splenectomies; 3 (1.9%) were subtotal gastrectomies; 3 (1.9%) were partial liver resections; and 2 (1.3%) were Nissen fundoplications. Ten (6.5%) early and 3 (1.9%) late postoperative complications were detected. No mortality or late morbidity (> 30 days) was detected due to SILS procedures. Conclusion SILS is a feasible technique in experienced hands for specific procedures. Meticulous patient selection is also important for good cosmetic results and outcomes.
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Affiliation(s)
- Enver Özkurt
- Department of General Surgery, Dana Farber Cancer Institute Harvard Medical School, Boston, United States
| | - Umut Barbaros
- Department of General Surgery, Istanbul University Faculty of Medicine, Istanbul University, İstanbul, Turkey
| | - Nihat Aksakal
- Department of General Surgery, Istanbul University Faculty of Medicine, Istanbul University, İstanbul, Turkey
| | - Selim Doğan
- Department of General Surgery, Istanbul Training and Research Hospital, İstanbul, Turkey
| | - Alp Bozbora
- Department of General Surgery, Istanbul University Faculty of Medicine, Istanbul University, İstanbul, Turkey
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Vilaça J, Pinto JP, Fernandes S, Costa P, Pinto JC, Leão P. Comparative Study of 2D and 3D Optical Imaging Systems: Laparoendoscopic Single-Site Surgery in an Ex Vivo Model. Surg Innov 2017; 24:598-604. [DOI: 10.1177/1553350617728160] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Affiliation(s)
- Jaime Vilaça
- Hospital da Arrábida, Luz Saúde, Portugal
- University of Minho, Braga, Portugal
| | | | | | - Patrício Costa
- University of Minho, Braga, Portugal
- ICVS/3B’s—PT Government Associate Laboratory, Guimarães, Braga, Portugal
| | - Jorge Correia Pinto
- University of Minho, Braga, Portugal
- ICVS/3B’s—PT Government Associate Laboratory, Guimarães, Braga, Portugal
| | - Pedro Leão
- Hospital de Braga, Braga, Portugal
- University of Minho, Braga, Portugal
- ICVS/3B’s—PT Government Associate Laboratory, Guimarães, Braga, Portugal
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Wakasugi M, Tei M, Omori T, Anno K, Mikami T, Tsukada R, Koh M, Gakuhara A, Furukawa K, Suzuki Y, Masuzawa T, Kishi K, Tanemura M, Akamatsu H. Single-incision laparoscopic surgery as a teaching procedure: a single-center experience of more than 2100 procedures. Surg Today 2016; 46:1318-24. [PMID: 26922213 DOI: 10.1007/s00595-016-1315-7] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2015] [Accepted: 01/26/2016] [Indexed: 12/19/2022]
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Weiss M, Mittermair C, Brunner E, Schirnhofer J, Obrist C, Pimpl K, Hell T, Weiss H. Inline radiofrequency pre-coagulation simplifies single-incision laparoscopic minor liver resection. JOURNAL OF HEPATO-BILIARY-PANCREATIC SCIENCES 2015; 22:831-6. [PMID: 26510122 DOI: 10.1002/jhbp.295] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
BACKGROUND Single-incision laparoscopy (SIL) has been developed to reduce surgical trauma, whereas technical difficulties in bleeding control limit the broad acceptance for hepatectomy. A novel minimized invasive strategy combining inline radiofrequency pre-coagulation and transumbilical SIL is presented herein. METHODS A cohort of 21 selected patients underwent transumbilical SIL hepatectomies (segmentectomies II-VI) utilizing inline radiofrequency pre-coagulation for hepatic transection (Habib 4X). Bleeding control, postoperative complications and positive resection margins in malignant diseases served as primary and secondary outcome parameters, respectively. RESULTS Single-incision laparoscopy was successfully completed in all patients. A total of 33 segments were retrieved: mean resection time was 66 ± 35 min, including 11 anatomical (52.38%) and 10 non-anatomical (47.62%) resections. Sixteen patients (76.19%) underwent concomitant abdominal surgery. No substantial blood loss occurred. Neither additional staplers nor clips were necessary to control any bleeding or bile leakage. One pleural effusion counted for the only postoperative complication. Free margins could be achieved in all but one resection (12/13 patients with malignancies; 92.31%). Ninety-day mortality was zero. CONCLUSIONS The combination of SIL and inline radiofrequency pre-coagulation proved to be a simple, efficacious and safe technique in minor hepatectomy.
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Affiliation(s)
- Michael Weiss
- Surgical Department, Saint John of God Hospital, Kajetanerplatz 1, 5010, Salzburg, Austria.,Teaching Hospital of the Paracelsus Private Medical University of Salzburg, Salzburg, Austria
| | - Christof Mittermair
- Surgical Department, Saint John of God Hospital, Kajetanerplatz 1, 5010, Salzburg, Austria.,Teaching Hospital of the Paracelsus Private Medical University of Salzburg, Salzburg, Austria
| | - Eberhard Brunner
- Surgical Department, Saint John of God Hospital, Kajetanerplatz 1, 5010, Salzburg, Austria.,Teaching Hospital of the Paracelsus Private Medical University of Salzburg, Salzburg, Austria
| | - Jan Schirnhofer
- Surgical Department, Saint John of God Hospital, Kajetanerplatz 1, 5010, Salzburg, Austria.,Teaching Hospital of the Paracelsus Private Medical University of Salzburg, Salzburg, Austria
| | - Christian Obrist
- Surgical Department, Saint John of God Hospital, Kajetanerplatz 1, 5010, Salzburg, Austria.,Teaching Hospital of the Paracelsus Private Medical University of Salzburg, Salzburg, Austria
| | - Katharina Pimpl
- Surgical Department, Saint John of God Hospital, Kajetanerplatz 1, 5010, Salzburg, Austria.,Teaching Hospital of the Paracelsus Private Medical University of Salzburg, Salzburg, Austria
| | - Tobias Hell
- Department of Mathematics, University of Innsbruck, Innsbruck, Austria
| | - Helmut Weiss
- Surgical Department, Saint John of God Hospital, Kajetanerplatz 1, 5010, Salzburg, Austria. .,Teaching Hospital of the Paracelsus Private Medical University of Salzburg, Salzburg, Austria.
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Sánchez-Margallo FM, Tapia-Araya A, Díaz-Güemes I. Preliminary application of a single-port access technique for laparoscopic ovariohysterectomy in dogs. Vet Rec Open 2015; 2:e000153. [PMID: 26568831 PMCID: PMC4640403 DOI: 10.1136/vetreco-2015-000153] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2015] [Revised: 09/05/2015] [Accepted: 10/05/2015] [Indexed: 11/04/2022] Open
Abstract
Laparoscopic ovariohysterectomy using single-portal access was performed in nine selected owned dogs admitted for elective ovariohysterectomy and the surgical technique and outcomes were detailed. A multiport device (SILS Port, Covidien, USA) was placed at the umbilical area through a single 3 cm incision. Three cannulae were introduced in the multiport device through the access channels and laparoscopic ovariohysterectomy was performed using a 5-mm sealing device, a 5-mm articulating grasper and a 5-mm 30° laparoscope. The mean total operative time was 52.66±15.20 minutes and the mean skin incision during surgery was 3.09±0.20 cm. Of the nine cases examined, in the one with an ovarian tumour, the technique was converted to multiport laparoscopy introducing an additional 5-mm trocar. No surgical complications were encountered and intraoperative blood loss was minimum in all animals. Clashing of the instruments and reduced triangulation were the main limitations of this technique. The combination of articulated and straight instruments facilitated triangulation towards the surgical field and dissection capability. One month after surgery a complete wound healing was observed in all animals. The present data showed that ovariohysterectomy performed with a single-port access is technically feasible in dogs. The unique abdominal incision minimises the abdominal trauma with good cosmetic results.
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Affiliation(s)
| | - A Tapia-Araya
- Centro de Cirugía de Mínima Invasión Jesús Usón , Cáceres , Spain
| | - I Díaz-Güemes
- Centro de Cirugía de Mínima Invasión Jesús Usón , Cáceres , Spain
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