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Single port laparoscopic surgery

Article information

J Korean Med Assoc. 2010;53(9):793-806
Publication date (electronic) : 2010 September 07
doi : https://doi.org/10.5124/jkma.2010.53.9.793
Woo-Jung Lee, MD
Department of Surgery, Yonsei University College of Medicine, Seoul, Korea. wjlee@yuhs.ac
Received 2010 July 07; Accepted 2010 July 21.

Abstract

Minimally invasive surgery and laparoscopic surgery have been used for more than 30 years, and are now popular even for some malignant diseases. There have been two developments in technology; one is robotic surgery and the other is less minimally invasive surgery like natural orifice transluminal endoscopic surgery (NOTES) and single port laparoscopic surgery. NOTES, using the current platform of a conventional fiberscope and side channel instruments for surgery, suffers many limitations, including image quality, flexibility of the fiberscope, size of the side channel, and difficulty of closing the opening. Due to the above-mentioned limitations, single port laparoscopic surgery has many advantages over. This review aims to define single port laparoscopic surgery and describe its terminology and technology. To perform single port laparoscopic surgery efficiently, new instruments (e.g., a laparoscopic camera, ports, laparoscopic instruments) and combining other innovative methods into surgery are both helpful. Even though there have been many developments in laparoscopic cameras, ports, and laparoscopic instruments to enhance single port laparoscopic surgery, further improvements are needed. Motorized instruments or using a robotic platform in combination with single port laparoscopic surgery will be another way to overcome the limitations of current single port laparoscopic surgery. Single port laparoscopic surgery is a technique that has recently emerged, but will be performed in a wider range of surgical procedures based on developments in laparoscopic cameras, ports and laparoscopic instrument technology.

Keywords: Single port laparoscopic surgery; Laparoscopic surgery; Minimally invasive surgery

References

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Article information Continued

Copyright © 2010 Korean Medical Association

This is an Open-Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Figure 1

Figure 1

Picture of 45 cm 45° angled bariatric length laparoscope with right angle light cable adapter and Instrument (upper) and 34 cm Standard 45° angled laparoscope and instrument.

Figure 2

Figure 2

Picture of making Glove port with Wound retracter and globe and conventional trocars (A, B, C) and (D) Outside view of single port laparoscopic cholecystectomy.

Figure 5

Figure 5

Picture of SILS™ Port (Covidien Inc, Norwalk, CT, USA: www.sils.com).

Figure 6

Figure 6

Uni-X™ Single Port Access with three working channels (Pnavel System, Inc).

Figure 7

Figure 7

Picture of AirSeal™ Port and Insufflator (SurgiQuest, Orange, CT, USA: www.surgiquest.com).

Figure 8

Figure 8

Picture of Glove Port (Nelis, Seoul, Korea).

Figure 9

Figure 9

(A) Picture of outer view during Single Port Laparoscopic Cholecystectomy using Glove port with 45°, 45 cm bariatric laparoscope and two 45 cm long instrument for retraction of GB fundus and Hartman's pouch and one Laparoangle instrument for dissection. (B) Picture of inner view during same operation.

Figure 10

Figure 10

Picture of Roticulator™ (Covidien, Norwalk, CT, USA : www.sils.com).

Figure 11

Figure 11

(A) Picture of Handle of Autonomy Laparoangle and (B) Picture of Slim Handle Model for Single Port Laparoscopic Surgery (CambridgeEndo, MA, USA: www.cambridgeendo.com).

Table 1

The acronyms single port laparoscopic surgery

Table 1

a)NOTES: Natural Orifice Transluminal Endoscopic Surgery

Table 2

Common problems of single port laparoscopic surgery

Table 2

Table 3

Technical tip of using instrument for easy single port laparoscopic surgery

Table 3