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The role of single-incision laparoscopic surgery in abdominal and pelvic surgery: a systematic review

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Abstract

Objective

This review aimed to determine the role of single-incision laparoscopic surgery (SILS) in abdominal and pelvic operations.

Data sources

The Medline, EMBASE, and PsycINFO databases were systematically searched until October 2009 using “single-incision laparoscopic surgery” and related terms as keywords. References from retrieved articles were reviewed to broaden the search

Study selection

The study included case reports, case series, and empirical studies that reported SILS in abdominal and pelvic operations.

Data extraction

Number of patients, type of instruments, operative time, blood loss, conversion rate, length of hospital stay, length of follow-up evaluation, and complications were extracted from the reviewed items

Data synthesis

The review included 102 studies classified as level 4 evidence. Most of these studies investigated SILS in cholecystectomy (n = 34), appendectomy (n = 24), and nephrectomy (n = 17). For these procedures, operative time, hospital stay, and complications were comparable with those of conventional laparoscopy. Conversion to conventional laparoscopy was seldom performed in cholecystectomy (range, 0–24%) and more frequent in appendectomy (range, 0–41%) and nephrectomy (range, 0–33%).

Conclusion

The potential benefits of SILS include superior cosmesis and possibly shorter operative time, lower costs, and a shortened time to full physical recovery. Careful case selection and a low threshold of conversion to conventional laparoscopic surgery are essential. Multicenter, randomized, prospective studies are needed to compare short- and long-term outcome measures against those of conventional laparoscopic surgery.

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Acknowledgments

Leonidas Nihoyannopoulos, BSc Psych, provided help with the literature search. We are grateful to Dr. Andre Chow for providing us with data and a figure on single-incision laparoscopic appendectomy and cholecystectomy.

Disclosures

Kamran Ahmed, Tim T. Wang, Vanash M. Patel, Kamal Nagpal, James Clark, Mariam Ali, Samer Deeba, Hutan Ashrafian, Ara Darzi, Thanos Athanasiou, and Paraskevas Paraskeva have no conflicts of interest or financial ties to disclose.

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  1. Department of Biosurgery and Surgical Technology, Imperial College London, 10th Floor, QEQM Building, St Mary’s Hospital Campus, Praed Street, London, W2 1NY, UK

    Kamran Ahmed, Tim T. Wang, Vanash M. Patel, Kamal Nagpal, James Clark, Mariam Ali, Samer Deeba, Hutan Ashrafian, Ara Darzi, Thanos Athanasiou & Paraskevas Paraskeva

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  1. Kamran Ahmed
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Ahmed, K., Wang, T.T., Patel, V.M. et al. The role of single-incision laparoscopic surgery in abdominal and pelvic surgery: a systematic review. Surg Endosc 25, 378–396 (2011). https://doi.org/10.1007/s00464-010-1208-6

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  • Issue Date:

  • DOI: https://doi.org/10.1007/s00464-010-1208-6

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