There are various factors to consider when choosing the proper tools to perform laparoscopic surgery through a single incision. To date, the single-incision approach appears just as safe as traditional laparoscopy1. If performed correctly, studies show single-incision procedures have improved cosmetic outcomes compared to traditional laparoscopic approaches and there is a trend towards a reduction in postoperative pain, both of which are very attractive to patients.
Pain is a factor that delays patient healing and is one of the leading factors that delays return to normal activities. In addition, a flexible port allows for easy insertion and removal of multiple surgical instruments and the camera through the port’s channels during the procedure. Unlike traditional laparoscopy where rigid tools are used, single-port approaches usually require at least one articulating instrument to achieve proper leverage, angles and access to the operating site inside the body.
For bariatric procedures, surgeons must consider longer articulating instruments to reach deep enough into the abdominal cavity of morbidly obese patients. Given that this is a new technique, surgeons should use the instruments that feel the most comfortable in their hands and will allow them to perform the procedure with as much confidence as a multi-incision approach.
1Marks J, Tacchino R, Roberts K, Onders R, Denoto G, Paraskeva P, Rivas H, Soper N, Rosemurgy A, Shah S: Prospective randomized controlled trial of traditional laparoscopic cholecystectomy versus single-incision laparoscopic cholecystectomy: Report of preliminary data, Am J Surg 2011; 201: 369-373