Single-incision laparoscopic surgery - current status and controversies.

Area of Science:

• Minimally Invasive Surgery
• Surgical Technology Advancement
• Laparoscopic Surgery

Background:

• Minimal Access Surgery (MAS) aims to reduce patient scarring and suffering.
• Laparoscopic surgery, pioneered in the late 1980s, became standard for many intra-abdominal procedures.
• Natural orifice translumenal endoscopic surgery (NOTES) aimed for scarless surgery but faced adoption challenges.

Purpose of the Study:

• To explore the evolution and current status of single-incision laparoscopic surgery (SILS).
• To compare SILS with other minimally invasive techniques like standard laparoscopy and NOTES.
• To provide an overview of existing and emerging SILS techniques and devices.

Main Methods:

• Review of the historical development of minimally invasive surgical techniques.
• Comparison of scar reduction strategies in laparoscopy, NOTES, and SILS.
• Analysis of technical challenges and advantages associated with SILS.

Main Results:

• Single-incision laparoscopic surgery (SILS) is an emerging modality further reducing scars from standard laparoscopy.
• NOTES has not gained widespread popularity, potentially increasing interest in SILS.
• SILS shares technical challenges with NOTES (e.g., access, triangulation) but offers a familiar view and instruments for surgeons.

Conclusions:

• SILS represents a significant step towards scarless surgery, bridging the gap between standard laparoscopy and NOTES.
• While SILS is technically feasible and used in various centers, it requires further development to become mainstream.
• The article provides a comprehensive overview of SILS techniques, devices, and future prospects in minimally invasive surgery.