TY - JOUR
T1 - Single-incision laparoscopic surgery
T2 - Initial urological experience and comparison with natural-orifice transluminal endoscopic surgery
AU - Raman, Jay D.
AU - Cadeddu, Jeffrey A
AU - Rao, Pradeep
AU - Rane, Abhay
N1 - Copyright:
Copyright 2008 Elsevier B.V., All rights reserved.
PY - 2008/6
Y1 - 2008/6
N2 - Laparoscopic approaches have increasingly assumed a central role in the management of benign and malignant surgical diseases. While laparoscopy is less morbid than open surgery, it still requires several incisions, each ≥1-2 cm long. Each incision risks morbidity from bleeding, hernia and/or internal organ damage, and incrementally decreases cosmesis. An alternative to conventional laparoscopy is single-incision laparoscopic surgery (SILS), in which articulating or bent instrumentation with specialized multi-lumen ports is used. These technical innovations obviate the need to externally space trocars for triangulation, thus allowing the creation of a small, solitary portal of entry into the abdomen. Laboratory and early clinical series showed the feasibility as well as safe and successful completion of SILS. Natural-orifice transluminal endoscopic surgery (NOTES) is another exciting development in minimally invasive urology, but existing flexible endoscopes and instruments are limited in providing a platform for this form of advanced surgery, resulting in the slow adoption of NOTES. Future work is needed to improve existing instrumentation, increase clinical experience, assess the benefits of both surgical approaches, and explore other potential applications for these novel techniques.
AB - Laparoscopic approaches have increasingly assumed a central role in the management of benign and malignant surgical diseases. While laparoscopy is less morbid than open surgery, it still requires several incisions, each ≥1-2 cm long. Each incision risks morbidity from bleeding, hernia and/or internal organ damage, and incrementally decreases cosmesis. An alternative to conventional laparoscopy is single-incision laparoscopic surgery (SILS), in which articulating or bent instrumentation with specialized multi-lumen ports is used. These technical innovations obviate the need to externally space trocars for triangulation, thus allowing the creation of a small, solitary portal of entry into the abdomen. Laboratory and early clinical series showed the feasibility as well as safe and successful completion of SILS. Natural-orifice transluminal endoscopic surgery (NOTES) is another exciting development in minimally invasive urology, but existing flexible endoscopes and instruments are limited in providing a platform for this form of advanced surgery, resulting in the slow adoption of NOTES. Future work is needed to improve existing instrumentation, increase clinical experience, assess the benefits of both surgical approaches, and explore other potential applications for these novel techniques.
KW - Minimally invasive surgery
KW - Natural-orifice transluminal endoscopic surgery
KW - One-port umbilical surgery
KW - Single-port access
UR - http://www.scopus.com/inward/record.url?scp=43949126206&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=43949126206&partnerID=8YFLogxK
U2 - 10.1111/j.1464-410X.2008.07586.x
DO - 10.1111/j.1464-410X.2008.07586.x
M3 - Short survey
C2 - 18325059
AN - SCOPUS:43949126206
SN - 1464-4096
VL - 101
SP - 1493
EP - 1496
JO - BJU international
JF - BJU international
IS - 12
ER -