Abstract
Laparoscopic surgery achieved high standards during the twentieth century. It is associated with lower morbidity, less pain, faster recovery, and a shorter hospital stay than open surgery. Is it, despite this achievement, still possible to make abdominal surgery simpler and safer, because it is the goal of every surgeon to minimize patient morbidity while maximizing the beneficial outcomes of the planned procedure? Most of the discomfort and complications associated with open and laparoscopic surgery are caused by the abdominal incisions: The longer is the incision, the stronger is the pain intensity and the higher is the risk for wound infection and hernia. To avoid this, it is necessary to perform surgical procedures without cutting the surface of the body and use natural openings as an entry to the abdomen or other parts of the body. Theoretical advantages of this natural orifice surgery (NOS) include less invasiveness by eliminating abdominal incisions, postoperative abdominal wall pain, wound infection, and hernia. Anthony Kalloo was the first to report an experimental transgastric peritoneoscopy [1]. When the gastroenterologists reached the intraperitoneal cavity through the wall of the stomach, the term natural orifice transluminal endoscopic surgery (NOTES) was introduced to describe procedures performed through natural body openings. As soon as other body openings became the target, this term became irrelevant because the vagina, for example, cannot be described as a lumen.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Kalloo AN, Singh VK, Jagannath SB, et al. Flexible transgastric peritoneoscopy: a novel approach to diagnostic and therapeutic interventions in the peritoneal cavity. Gastrointest Endosc. 2004;60:114–7.
Stark M, Benhidjeb T. Transcolonic endoscopic cholecystectomy: a NOTES survival study in a porcine model. Gastrointest Endosc. 2007;66:208–9.
Rattner D, Kalloo A. ASGE/SAGES working group on natural orifice transluminal endoscopic surgery. Surg Endosc. 2006;20:329–33.
Stark M, Benhidjeb T. Natural orifice surgery: transdouglas surgery—a new concept. JSLS. 2008;12:295–8.
Zorrón R, Filgueiras M, Maggioni LC, et al. NOTES transvaginal cholecystectomy: report of the first case. Surg Innov. 2007;14:279–83.
Bessler M, Stevens PD, Milone L, et al. Transvaginal laparoscopically assisted endoscopic cholecystectomy: a hybrid approach to natural orifice surgery. Gastrointest Endosc. 2007;66:1243–5.
Marescaux J, Dallemagne B, Perretta S, et al. Surgery without scars: report of transluminal cholecystectomy in a human being. Arch Surg. 2007;142:823–6; discussion 826–27.
Swanstrom LL, Whiteford M, Khajanchee Y. Developing essential tools to enable transgastric surgery. Surg Endosc. 2008;22:600–4.
Gill IS, Canes D, Aron M, Haber GP, Goldfarb DA, Flechner S, et al. Single-port transumbilical (E-NOTES) donor nephrectomy. J Urol. 2008;180:637–41; discussion 641.
Canes D, Desai MM, Aron M, Haber GP, Goel RK, Stein RJ, et al. Transumbilical single-port surgery: evolution and current status. Eur Urol. 2008;54:1020–9.
Desai MM, Stein R, Rao P, Canes D, Aron M, Rao PP, et al. Embryonic natural orifice transumbilical endoscopic surgery (E-NOTES) for advanced reconstruction: initial experience. Urology. 2009;73:182–7.
Nguyen NT, Reavis KM, Hinojosa MW, Smith BR, Wilson SE. Laparoscopic transumbilical cholecystectomy without visible abdominal scars. J Gastrointest Surg. 2009;13:1125–8.
Rao P, Rao S, Rané A, Bondaio F, Rao P. Evaluation of the R-port for single laparoscopic port procedures (SLAPP): a study of 20 cases. Surg Endosc. 2008;22 Suppl 1:S279.
Remzi FH, Kirat HT, Kaouk JH, Geisler DP. Single-port laparoscopy in colorectal surgery. Colorectal Dis. 2008;10:823–6.
Kaouk JH, Goel RK, Haber GP, Crouzet S, Desai MM, Gill IS. Single-port laparoscopic radical prostatectomy. Urology. 2008;72:1190–3.
Nguyen NT, Hinojosa MW, Smith BR, Reavis KM. Single laparoscopic incision transabdominal (SLIT) surgery-adjustable gastric banding: a novel minimally invasive surgical approach. Obes Surg. 2008;18:1628–31.
Wittmoser R. Thorakoskopische operationen am mediastinalen vagus. Langenbecks Arch Klin Chir. 1957;287:230–3.
Wittmoser R. Endoskopische sympathicotomie bei hyperhidrosis und raynaud-syndrom. Langenbecks Arch Chir. 1973;334:971–2.
Wheeless CR. A rapid, inexpensive, and effective method of surgical sterilization by laparoscopy. J Reprod Med. 1969;5:255.
Pelosi MA. Laparoscopic hysterectomy with bilateral salpingo-oophorectomy using a single umbilical puncture. N J Med. 1991;88:721–6.
Pelosi MA, Pelosi 3rd MA. Laparoscopic appendectomy using a single umbilical puncture (minilaparoscopy). J Reprod Med. 1992;37:588–94.
Navarra G, Pozza E, Occhionorelli S, Carcoforo P, Donini I. One-wound laparoscopic cholecystectomy. Br J Surg. 1997;84:695.
Esposito C. One-trocar appendectomy in pediatric surgery. Surg Endosc. 1998;12:177–8.
Piskun G. Transumbilical laparoscopic cholecystectomy utilizes no incisions outside the umbilicus. J Laparoendosc Adv Surg Tech A. 1999;9:361–4.
Kagaya T. Laparoscopic cholecystectomy via two ports using the “Twin-Port” system. J Hepatobiliary Pancreat Surg. 2001;8:76–80.
Ahmed K, Wang TT, Patel VM, Nagpal K, Clark J, Ali M, et al. The role of single-incision laparoscopic surgery in abdominal and pelvic surgery: a systematic review. Surg Endosc. 2011;25:378–96.
Box G, Averch T, Cadeddu J, Cherullo E, Clayman R, Desai M, et al. Nomenclature of Natural Orifice Transluminal Endoscopic Surgery (NOTES) and Laparoendoscopic Single-Site Surgery (LESS) procedures in urology. J Endourol. 2008;22:2575–81.
Gill IS, Advincula AP, Aron M, Caddedu J, Canes D, Curcillo 2nd PG, et al. Consensus statement of the consortium for laparoendoscopic single-site surgery. Surg Endosc. 2010;24:762.
McCloy R, Randall D, Schug SA, Kehlet H, Simanski C, Bonnet F, et al. Is smaller necessarily better? A systematic review comparing the effects of minilaparoscopic and conventional laparoscopic cholecystectomy on patient outcomes. Surg Endosc. 2008;22:2541–53.
Hasson HM, Rotman C, Rana N, et al. Open laparoscopy: 29 year experience. Obstet Gynecol. 2000;96:763–6.
Gaynes RP, Culver DH, Horan TC, et al. Surgical site infection rates in the United States, 1992–1998: the National Nosocomial Infections Surveillance System basic SSI risk index. Clin Infect Dis. 2001;33 Suppl 2:S69–77.
Hamzaoglu I, Baca B, Böler DE, Polat E, Özer Y. Is umbilical flora responsible for wound infection after laparoscopic surgery? Surg Laparosc Endosc Percutan Tech. 2004;14:263–7.
Schwenk W, Haase O, Neudecker JJ, Müller JM. Short term benefits for laparoscopic colorectal resection. Cochrane Database Syst Rev. 2005;3:CD003145.
Voitk AJ, Tsao SG. The umbilicus in laparoscopic surgery. Surg Endosc. 2001;15:878–81.
Bowrey DJ, Blom D, Crookes PF, et al. Risk factors and the prevalence of trocar site herniation after laparoscopic fundoplication. Surg Endosc. 2001;15:663–6.
Susmallian S, Ezri T, Charuzi I. Laparoscopic repair of access port site hernia after Lap-Band system implantation. Obes Surg. 2002;12:682–4.
Barry M, Winter C. Laparoscopic port site hernias: any port in a storm or a storm in any port? Ann Surg. 2008;248:687–8.
Nassar AH, Ashkar KA, Rashed AA, et al. Laparoscopic cholecystectomy and the umbilicus. Br J Surg. 1997;84:630–3.
Khanna R, White MA, Autorino R, Laydner HK, Isac W, Yang B, et al. Selection of a port for use in laparoendoscopic single-site surgery. Curr Urol Rep. 2011;12(2):94–9.
Romanelli JR, Earle DB. Single-port laparoscopic surgery: an overview. Surg Endosc. 2009;23:1419–27.
Burgos JB, Flores JA, de la Vega JS, et al. Early experience in laparoscopic radical prostatectomy using the laparoscopic device for umbilical access SILS port. Actas Urol Esp. 2010;34:495–9.
Liberati A, Altman DG, Tetzlaff J, Mulrow C, Gøtzsche PC, Ioannidis JP, et al. The PRISMA statement for reporting systematic reviews and metaanalyses of studies that evaluate health care interventions: explanation and elaboration. BMJ. 2009;339:b2700.
EBM Oxford centre for evidence-based medicine 2009. www.cebm.net/levels_of_evidence.
Boni L, Dionigi G, Cassinotti E, Di Giuseppe M, Diurni M, Rausei S, et al. Single incision laparoscopic right colectomy. Surg Endosc. 2010;24:3233–6.
Ramos-Valadez DI, Patel CB, Ragupathi M, Bartley Pickron T, Haas EM. Single-incision laparoscopic right hemicolectomy: safety and feasibility in a series of consecutive cases. Surg Endosc. 2010;24:2613–6.
Vestweber B, Alfes A, Paul C, Haaf F, Vestweber KH. Single-incision laparoscopic surgery: a promising approach to sigmoidectomy for diverticular disease. Surg Endosc. 2010;24:3225–8.
Gash KJ, Goede AC, Chambers W, Greenslade GL, Dixon AR. Laparoendoscopic single-site surgery is feasible in complex colorectal resections and could enable day case colectomy. Surg Endosc. 2011;25:835–40.
Wheeless Jr CR, Thompson BH. Laparoscopic sterilization. Review of 3600 cases. Obstet Gynecol. 1973;42:751–8.
Park HS, Kim TJ, Song T, Kim MK, Lee YY, Choi CH, et al. Single-port access (SPA) laparoscopic surgery in gynecology: a surgeon’s experience with an initial 200 cases. Eur J Obstet Gynecol Reprod Biol. 2011;154:81–4.
Jung YW, Lee M, Yim GW, Lee SH, Paek JH, Kwon HY, et al. A randomized prospective study of single-port and four-port approaches for hysterectomy in terms of postoperative pain. Surg Endosc. 2011;25(8):2462–9. doi:10.1007/s00464-010-1567-z.
Author information
Authors and Affiliations
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2012 Springer-Verlag London Limited
About this chapter
Cite this chapter
Benhidjeb, T., Stark, M., Izbicki, J.R., Mann, O. (2012). Single-Access Surgery: Less Is More?. In: Tinelli, A. (eds) Laparoscopic Entry. Springer, London. https://doi.org/10.1007/978-0-85729-980-2_8
Download citation
DOI: https://doi.org/10.1007/978-0-85729-980-2_8
Published:
Publisher Name: Springer, London
Print ISBN: 978-0-85729-979-6
Online ISBN: 978-0-85729-980-2
eBook Packages: MedicineMedicine (R0)