Single Incision Endo-laparoscopic Surgery a Prospective Study

Endo-laparoscopic surgery has evolved dramatically since the first laparoscopic cholecystectomy 20 years ago but today a newest concept of single port endo-laparoscopic surgery (SPES) is becoming popular. The advantages of this novel approach seems to be the less invasiveness by reducing the number of incisions and the less postop pain. Certainly, new instruments and additional training is required. In our study, we prospectively evaluate the clinical outcome of patients undergoing SPES.

From May to August 2009, data from patients undergoing SPES were prospectively collected. Patient demographics, type of operation, duration, complications intra and post operatively, incision size, postoperative pain score and hospital stay were collected and analyzed using the SPSS software. SPES was done either by using the LESS™ device (Olympus, Japan) or the SILS™ port (Covidien, USA).

Twenty nine patients (13 females) underwent surgery (Table) with a median age of 54 years (range 20-80) underwent SPES and 2 pts had double procedures in different abdominal quadrants. No intraoperative complications occurred. 1 pt developed wound infection and3 pts a seroma. 1 case was converted to a standard procedure. In another case an additional 5mm port was necessary to complete the diaphragmatic hernia repair. The median VAS pain score upon discharge was 3 (range 0-4) and 1 after 1 week of follow-up. The average incision size was 2.6cm.

In our experience, SPES has the advantage of better cosmesis and less pain. The challenges we encountered are the decreased triangulation and the instrument-handle conflict. SPES is feasible and safe and can be applied to wider endoscopic procedures. However, a larger sample population and a randomized control trial are needed to further evaluate the benefit of this new technique.

Procedure Total

OT time

(min)

Add 5 mm port Mean incision size (cm) Conversion to standard lap Hosp Stay (hrs)
Inguinal Hernia 11 86.09 0 2.40 0 19.36
Ventral Hernia 1 100 0 2.50 0 48
Thyroidectomy 3 152.67 0 3.50 1 23
Adrenalectomy 4 99.25 0 2.75 0 36.25
Cholecystectomy 6 118.50 0 2.58 0 21.67
Oophorectomy 1 100 0 3.00 0 23
Appendectomy 1 55 0 2.50 0 48
Double Procedure 2 230 1 2.50 0 59.50

Session: Poster

Program Number: P515

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