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Single‐incision laparoscopic surgery: initial urological experience and comparison with natural‐orifice transluminal endoscopic surgery
Author(s) -
Raman Jay D.,
Cadeddu Jeffrey A.,
Rao Pradeep,
Rane Abhay
Publication year - 2008
Publication title -
bju international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.773
H-Index - 148
eISSN - 1464-410X
pISSN - 1464-4096
DOI - 10.1111/j.1464-410x.2008.07586.x
Subject(s) - medicine , natural orifice transluminal endoscopic surgery , cosmesis , laparoscopy , surgery , laparoscopic surgery , invasive surgery , endoscopy , endoscopic surgery , general surgery , abdominal surgery
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.