Single Incision Laparoscopic Surgery Development at the Hospital Clinic: Our 4-Year Experience
Author(s)
Josep Martí,
Oscar Vidal*,
Mauro Valentini,
Cesar Ginestà,
Juan José Espert,
Miss Yolanda Rodriguez,
Guerson Benarroch,
Juan Carlos García-Valdecasas
ABSTRACT
Background: Single incision laparoscopic surgery (SILS) has still not replaced conventional laparoscopic surgery in many centers because of its special instruments requirements and training needs. In our Institution we introduced SILS procedures in a procedural stepwise manner, with progression to more difficult procedures only allowed if complete proficiency in low-complexity ones is achieved. Methods: We studied the evolution of performed SILS procedures in our Institution from the beginning of the program (mainly appendectomies, cholecystectomies, left adrenalectomies) and the results from these techniques. Results: Among 328 SILS procedures there were 148 appendectomies (24 by suprapubic access), 141 cholecystectomies, 32 left adrenalectomies, 6 diagnostic laparoscopies and 1 resection of Meckel’s diverticulum. The majority of appendectomies accounted for non-perforated appendicitis cases and there were no significant differences between transumbilical and suprapubic access groups. In cholecystectomies the majority of patients were elective cases and oral intake could be resumed within the 6 postoperative hours. In left adrenalectomies no conversion to open surgery was required and there were no intraoperative or postoperative complications. Conclusions: Procedural stepwise approach in SILS is a valid, feasible and safe option that can be applied at any institution starting a SILS program.
Cite this paper
Martí, J. , Vidal, O. , Valentini, M. , Ginestà, C. , Espert, J. , Rodriguez, M. , Benarroch, G. and García-Valdecasas, J. (2015) Single Incision Laparoscopic Surgery Development at the Hospital Clinic: Our 4-Year Experience. International Journal of Clinical Medicine, 6, 26-32. doi: 10.4236/ijcm.2015.61004.
Martí, J. , Vidal, O. , Valentini, M. , Ginestà, C. , Espert, J. , Rodriguez, M. , Benarroch, G. and García-Valdecasas, J. (2015) Single Incision Laparoscopic Surgery Development at the Hospital Clinic: Our 4-Year Experience. International Journal of Clinical Medicine, 6, 26-32. doi: 10.4236/ijcm.2015.61004.
References
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http://dx.doi.org/10.1007/s00268-011-1059-x [6] Mazzaglia, P.J. and Vezeridis, M.P. (2010) Laparoscopic Adrenalectomy: Balancing the Operative Indications with the Technical Advances. Journal of Surgical Oncology, 101, 739-744. [7] Edwin, B., Nordin, A. and Kazaryan, A.M. (2011) Laparoscopic Liver Surgery: New Frontiers. Scandinavian Journal of Surgery, 100, 54-65. [8] Tsai, A.Y. and Selzer, D.J. (2010) Single-Port Laparoscopic Surgery. Advances in Surgery, 44, 1-27.
http://dx.doi.org/10.1016/j.yasu.2010.05.017 [9] Tang, B., Hou, S. and Cuschieri, S.A. (2012) Ergonomics of and Technologies for Single-Port Laparoscopic Surgery. Minimally Invasive Therapy & Allied Technologies, 21, 46-54.
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http://dx.doi.org/10.1016/j.ciresp.2009.01.003 [13] Vidal, O., Valentini, M., Ginestà, C., Martí, J., Espert, J.J., Benarroch, G. and García-Valdecasas, J.C. (2010) Laparoen-doscopic Single-Site Surgery Appendectomy. Surgical Endoscopy, 24, 686-691.
http://dx.doi.org/10.1007/s00464-009-0661-6 [14] Vidal, O., Valentini, M., Ginestà, C., Espert, J.J., Martinez, A., Benarroch, G., Anglada, M.T. and García-Valdecasas, J.C. (2011) Single-Incision Versus Standard Laparoscopic Cholecystectomy: Comparison of Surgical Outcomes from a Single Institution. Journal of Laparoendoscopic & Advanced Surgical Techniques A, 21, 683-686.
http://dx.doi.org/10.1089/lap.2011.0047 [15] Vidal, O., Pavel, M., Valentini, M., Ginesta, C., Martí, J., Espert, J.J., Benarroch, G. and García-Valdecasas, J.C. (2012) Single-Incision Laparoscopic Cholecystectomy for Day Surgery Procedure: Are We Prepared? The American Surgeon, 78, 436-439. [16] Vidal, O., Astudillo, E., Valentini, M., Ginestà, C., García-Valdecasas, J.C. and Fernandez-Cruz, L. (2012) Single-Incision Transperitoneal Laparoscopic Left Adrenalectomy. World Journal of Surgery, 36, 1395-1399.
http://dx.doi.org/10.1007/s00268-012-1555-7 [17] Zacharias, M., Haese, A., Jurczok, A., Stolzenburg, J.U. and Fornara, P. (2006) Transperitoneal Laparoscopic Adrenalectomy: Outline of the Preoperative Management, Surgical Approach, and Outcome. European Urology, 49, 448-459.
http://dx.doi.org/10.1016/j.eururo.2006.01.014
[1] Tiwari, M.M., Reynoso, J.F., High, R., Tsang, A.W. and Oleynikov, D. (2011) Safety, Efficacy, and Cost-Effectiveness of Common Laparoscopic Procedures. Surgical Endoscopy, 25, 1127-1135.
http://dx.doi.org/10.1007/s00464-010-1328-z [2] Vettoretto, N. and Agresta, F. (2011) A Brief Review of Laparoscopic Appendectomy: The Issues and the Evidence. Techniques in Coloproctology, 15, 1-6. http://dx.doi.org/10.1007/s10151-010-0656-2 [3] Keus, F., Gooszen, H.G. and van Laarhoven, C.J. (2010) Open, Small-Incision, or Laparoscopic Cholecystectomy for Patients with Symptomatic Cholecystolithiasis. An Overview of Cochrane Hepato-Biliary Group Reviews. Cochrane Database of Systematic Reviews, 20, CD008318. [4] Aly, E.H. (2009) Laparoscopic Colorectal Surgery: Summary of the Current Evidence. Annals of the Royal College of Surgeons of England, 91, 541-544. http://dx.doi.org/10.1308/003588409X464757 [5] Feldman, L.S. (2011) Laparoscopic Splenectomy: Standardized Approach. World Journal of Surgery, 35, 1487-1495.
http://dx.doi.org/10.1007/s00268-011-1059-x [6] Mazzaglia, P.J. and Vezeridis, M.P. (2010) Laparoscopic Adrenalectomy: Balancing the Operative Indications with the Technical Advances. Journal of Surgical Oncology, 101, 739-744. [7] Edwin, B., Nordin, A. and Kazaryan, A.M. (2011) Laparoscopic Liver Surgery: New Frontiers. Scandinavian Journal of Surgery, 100, 54-65. [8] Tsai, A.Y. and Selzer, D.J. (2010) Single-Port Laparoscopic Surgery. Advances in Surgery, 44, 1-27.
http://dx.doi.org/10.1016/j.yasu.2010.05.017 [9] Tang, B., Hou, S. and Cuschieri, S.A. (2012) Ergonomics of and Technologies for Single-Port Laparoscopic Surgery. Minimally Invasive Therapy & Allied Technologies, 21, 46-54.
http://dx.doi.org/10.3109/13645706.2011.627924 [10] Podolsky, E.R. and Curcillo 2nd, P.G. (2010) Single Port Access (SPA) Surgery—A 24-Month Experience. Journal of Gastrointestinal Surgery, 14, 759-767. http://dx.doi.org/10.1007/s11605-009-1081-6 [11] Khandelwal, S., Wright, A.S., Figueredo, E., Pellegrini, C.A. and Oelschlager, B.K. (2011) Single-Incision Laparoscopy: Training, Techniques, and Safe Introduction to Clinical Practice. Journal of Laparoendoscopic & Advanced Surgical Techniques A, 21, 687-693. http://dx.doi.org/10.1089/lap.2011.0238 [12] Vidal, O., Valentini, M., Ginestà, C., Benarroch, G. and García-Valdecasas, J.C. (2009) Single Incision Laparoscopic Appendectomy (SILS): Initial Experience. Cirugía Española, 85, 317-319.
http://dx.doi.org/10.1016/j.ciresp.2009.01.003 [13] Vidal, O., Valentini, M., Ginestà, C., Martí, J., Espert, J.J., Benarroch, G. and García-Valdecasas, J.C. (2010) Laparoen-doscopic Single-Site Surgery Appendectomy. Surgical Endoscopy, 24, 686-691.
http://dx.doi.org/10.1007/s00464-009-0661-6 [14] Vidal, O., Valentini, M., Ginestà, C., Espert, J.J., Martinez, A., Benarroch, G., Anglada, M.T. and García-Valdecasas, J.C. (2011) Single-Incision Versus Standard Laparoscopic Cholecystectomy: Comparison of Surgical Outcomes from a Single Institution. Journal of Laparoendoscopic & Advanced Surgical Techniques A, 21, 683-686.
http://dx.doi.org/10.1089/lap.2011.0047 [15] Vidal, O., Pavel, M., Valentini, M., Ginesta, C., Martí, J., Espert, J.J., Benarroch, G. and García-Valdecasas, J.C. (2012) Single-Incision Laparoscopic Cholecystectomy for Day Surgery Procedure: Are We Prepared? The American Surgeon, 78, 436-439. [16] Vidal, O., Astudillo, E., Valentini, M., Ginestà, C., García-Valdecasas, J.C. and Fernandez-Cruz, L. (2012) Single-Incision Transperitoneal Laparoscopic Left Adrenalectomy. World Journal of Surgery, 36, 1395-1399.
http://dx.doi.org/10.1007/s00268-012-1555-7 [17] Zacharias, M., Haese, A., Jurczok, A., Stolzenburg, J.U. and Fornara, P. (2006) Transperitoneal Laparoscopic Adrenalectomy: Outline of the Preoperative Management, Surgical Approach, and Outcome. European Urology, 49, 448-459.
http://dx.doi.org/10.1016/j.eururo.2006.01.014