Single Incision Laparoscopic Surgery Development at the Hospital Clinic: Our 4-Year Experience

Josep Martí, Oscar Vidal^*, Mauro Valentini, Cesar Ginestà, Juan José Espert, Miss Yolanda Rodriguez, Guerson Benarroch, Juan Carlos García-Valdecasas

General Surgery and Emergency Unit, Department of General and Digestive Surgery, Digestive Diseases and Metabolism Institute, Hospital Clínici Provincial, Universitat de Barcelona, IDIBAPS, Barcelona, Spain.

DOI: 10.4236/ijcm.2015.61004                

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.

Keywords

Adrenal, Appendix, Cholecystectomy, Training/Courses, Education

Conflicts of Interest

The authors declare no conflicts of interest.

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