Journal of Surgery and Interventional Radiology

Single-port laparoscopy (SPL)

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Single-port laparoscopy also referred to as single-incision laparoscopic surgery or laparo-endoscopic single-site surgery is an advanced minimally invasive surgical technique wherein operations are conducted through a singular entry point, typically the patient's umbilicus. This approach contrasts with traditional multi-port laparoscopic methods by reducing the number of incisions, thereby aiming to minimize postoperative scarring and discomfort.?

The SPL procedure involves creating a single incision, generally between 11 to 20 millimeters in length, at the navel. Through this access point, specialized ports are introduced to facilitate the insertion of multiple laparoscopic instruments. These access ports include devices such as the GelPOINT system, SILS device, TriPort+, and Uni-X. Surgeons may utilize standard rigid instruments or opt for articulating and pre-bent rigid instruments designed to enhance maneuverability within the confined space, thereby addressing the challenge of reduced triangulation inherent in SPL.?

The application of SPL spans various surgical disciplines. In general surgery, it has been employed for procedures like cholecystectomy, appendectomy, and hernia repair. In the realm of urology, SPL facilitates nephrectomy and prostatectomy, while gynecological applications include hysterectomy and ovarian cystectomy. The versatility of SPL underscores its potential to become a standard approach across multiple surgical fields.?

Potential advantages of SPL over conventional laparoscopic techniques encompass reduced postoperative pain, diminished blood loss, expedited recovery times, and enhanced cosmetic outcomes due to the singular, concealed incision within the umbilicus. However, these benefits must be weighed against possible complications, such as significant postoperative pain, injury to organs, bleeding, infection, incisional hernia, intestinal adhesions, and scarring.?

The evolution of SPL can be traced back to the late 1990s, with the first notable procedure—a gallbladder removal—documented in 1997. Since then, the technique has gained momentum, with thousands of SPL procedures performed globally across various surgical specialties. As the technique continues to evolve, it holds promise for further enhancing patient outcomes and expanding the horizons of minimally invasive surgery.?