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Single Port Surgery Advancing, But There Is Still More To Learn

Wed, 10/21/2009 - 7:27am
Amanda McGowan, editor

From recent procedural and technological advances in surgery, there is a strong indication that Single Port Surgery is increasingly being practiced in the OR. Manufacturers are increasingly working to provide technology to make single port surgeries easier and more efficient in the OR, and surgeons are consistently advancing the technique on the surgical patients.

Several studies presented at the Society of Laparoendoscopic Surgeons meeting in September 2009 support that Single Port Surgery is a feasible, safe and often preferred alternative to traditional laparoscopy or open surgery for the right surgical candidates.

However, with these positive indications for Single Port Surgery in the near future come with a caution: more research is needed on the topic. While many surgeons acknowledge the feasibility of Single Port Surgery, some question whether it’s a better option for a laparoscopic procedure in the OR.

In a study performed by Sujit Vijay Sakpal, MD, et al, the researchers evaluated the benefits of performing a SILS or NOTES cholecystectomy. Their comprehensive review of worldwide literature determined that SILS and NOTES cholecystectomy have the potential to reduce cosmetic benefits.

However, are these procedural advances just about cosmesis? The study concluded that whether SILS and NOTES offered other benefits, such as less postoperative pain, was subjective and lacked objective data to support the claim. Additionally, the researchers could not make definite claims that SILS and NOTES reduced intraoperative or postoperative complication rates and the safety and efficacy associated the procedures remained undetermined.

In an examination of gynecologic cases, Stefanos Chandakos, MD, MBA, PhD, looked to demonstrate the safety and feasibility of single port laparoscopy in gynecology. The study analyzed 35 patients who underwent the single port procedure and concluded the procedures were safe and feasible with cosmetic result and postoperative pain better accepted by the patients. Meanwhile, surgical time, safety and feasibility were the same. The study called for additional research to be performed and new instrumentation to perform complicated cases.

The above-mentioned studies are just two of several studies examining the true benefits of single port surgery. While the cosmesis benefits are well-known, these procedures must prove to be feasible, safe and an improved alternative for some patients to really become the standard of care in the operating room. While the clear-cut benefits of the single port procedures are still a little foggy, additional research will help identify the true benefits of single port surgery, and move the associated procedural and technological advancements into the future.

Source: JSLS Supplement

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