scholarly journals Application of Iconport single incision sealing device in laparoscopic surgery.(Experience in 125 cases of appendectomy)

2019 ◽  
Author(s):  
Xiaojun Wang ◽  
Haibo Jin ◽  
YongFeng Shuai ◽  
YiZhong Zhang

Abstract Background To discuss the reliability and clinical value of Iconport, a Self-made single port device, which was applied for transumbilical single port laparoscopic appendectomy. Methods The incision was around 2.5 cm long with curved form around umbilicus. And the skin and each layer of the abdominal wall were cut in sequence. Then the silica gel sleeve of the self-made single-incision sealing device was folded, clamped by the forceps, and carefully inserted into the incision for sealing. The operation of laparoscopic appendectomy was accomplished by-use routine linetype laparoscopic instruments via Iconport. The specimen was discharged from peritoneal cavity through the single port device. Two layers of incision, linea alba abdominus and skin, were separately sutured by absorbable thread and each layer was sutured successively. Results Among the 125 patients, 119 were successfully performed single-port laparoscopic appendectomy, with the operation time ranging from 30 to 110 min (69.34±21.4 min on average). In 6 cases, auxiliary operating hole was added or laparotomy was performed. Total hospital stay was 5.0±1.8 (2-14) days. 5 cases of incision infection. All patients were followed up for 1 to 6 months after surgery, with an average of 3 months. There were no complications such as bleeding, intestinal leakage, intestinal obstruction, and residual peritoneal effusion. Conclusion In single-incision laparoscopic surgery, the u-shaped incision around the umbilical margin of 2.5cm for adult can not only meet the requirements of flexibility of instruments in the operation, but also meet the aesthetic requirements because the incision scar is hidden in the umbilical foramen or looks like the umbilical foramen after the operation. Iconport single-hole device, which has potential promotion value, can be used in relatively simple laparoscopic surgery alone or combined with a single puncture device for relatively complex laparoscopic surgery.

2019 ◽  
Author(s):  
Xiaojun Wang ◽  
Yizhong Zhang ◽  
Changlei Qi ◽  
Encheng Zhou ◽  
Haiqiang Zhang ◽  
...  

Abstract Background Since 2008, the first case of Single-incision laparoscopic surgery totally extraperitoneal (SILS-TEP) was reported, there was more than 10 years history on SILS-TEP. Because of difficult to operation, SILS-TEP is popularized slowly. This study investigate the safety and feasibility of SILS-TEP under posterior rectus abdominis sheath. Methods A single 2.5cm long cured incision was made along the lower umbilical border. A 5.0cm size preperitoneal space was created by electrotome or blunt dissection under the posterior sheath and the linea alba. The silica gel sealing sleeve of Iconport single port device was crammthed under the posterior rectus abdominis sheath, then the preperitoneal space was broadened toward lower abdomen in condition of CO2 gas inflation. Conventional laparoscopic instruments were used to complete the operation according to the operation procedure of laparoscopic total extraperitoneal herniorrhaphy. Results SILS-TEP hernia repair was successfully completed in 39 patients. One need an additional ports to complete totally extraperitoneal hernioplasty. Mean operative time was 73.8 minutes (range, 45 to 130 minutes) and 55.2 minutes (range, 34 to 95 minutes) in unilateral indirect hernia and in unilateral direct or femoral hernia, respectively . Mean operative time was 92.3 minutes (range, 65 to 150 minutes) in bilateral hernia. 3 seroma and 5 chronic pain were seen during the 1-6 months follow-up periods, all were treated conservatively. No other major complications. Mean post-operative hospital stay was 2.6 days. Conclusion The operation of SILS-TEP via umbilical incision under posterior rectus abdominis sheath is safe and feasible. The Iconport single-port device has potential advantages in SILS-TEP surgery. Trial registration: The study was registered with the Chinese Clinical Trial Registry (ChiCTR)(www.chictr.org.cn).Registration number:ChiCTR1900023056. Registration date: May 9, 2019.Retrospectively registered.


2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Toshio Shiraishi ◽  
Tetsuro Tominaga ◽  
Takashi Nonaka ◽  
Kiyoaki Hamada ◽  
Masato Araki ◽  
...  

AbstractSingle-incision laparoscopic surgery (SILS) has the potential to improve perioperative outcomes, including less postoperative pain, shorter operation time, less blood loss, and shorter hospital stay. However, SILS is technically difficult and needs a longer learning curve. Between April 2016 and September 2019, a total of 198 patients with clinical stage I/II right colon cancer underwent curative resection. In the case of the SILS approach, an organ retractor was usually used to overcome SILS-specific restrictions. The patients were divided into two groups by surgical approach: the SILS with organ retractor group (SILS-O, n = 33) and the conventional laparoscopic surgery group (LAC, n = 165). Clinical T status was significantly higher in the LAC group (p = 0.016). Operation time was shorter and blood loss was lower in the SILS-O group compared to the LAC group (117 vs. 197 min, p = 0.027; 10 vs. 25 mL, p = 0.024, respectively). In the SILS-O group, surgical outcomes including operation time, blood loss, number of retrieved lymph nodes, and postoperative complications were not significantly different between those performed by experts and by non-experts. Longer operation time (p = 0.041) was significantly associated with complications on univariate and multivariate analyses (odds ratio 2.514, 95%CI 1.047–6.035, p = 0.039). SILS-O was safe and feasible for right colon cancer. There is a potential to shorten the learning curve of SILS using an organ retractor.


ASVIDE ◽  
2016 ◽  
Vol 3 ◽  
pp. 352-352
Author(s):  
Benedetta Bedetti ◽  
Pierfiorgio Solli ◽  
David Lawrence ◽  
Nikolaos Panagiotopoulos ◽  
Martin Hayward ◽  
...  

2018 ◽  
Vol 5 (12) ◽  
pp. 3852 ◽  
Author(s):  
Sahil Rometra ◽  
Rahil Rometra ◽  
Neeraj Koul ◽  
R. K. Chrungoo

Background: Appendicitis is primarily a disease of adolescents and young adults with a peak incidence in the second and third decades of life. Appendectomy for appendicitis is the most commonly performed emergency operation in the world.For more than a century, open appendectomy remained the gold standard for the treatment of acute appendicitis.  Laparoscopic surgery has become popular universally during the last couple of decades.   Efforts are still being made to decrease abdominal incision and visible scars after laparoscopy.  Single incision laparoscopic surgery (SILS) is a new innovation allowing minimal access surgery to be performed through a single umbilical incision.Methods: It was a prospective study carried out on 50 patients diagnosed as acute appendicitis. They were divided into two groups of 25 each. One group underwent Conventional Laparoscopic Appendectomy (CLA) and other group underwent Single Incision Laparoscopic Surgery (SILS).  Results were compared with regard to mean operative time,   complications, post-operative pain and discomfort (vas score at 12 hours), post-operative morbidity, duration of hospital stay and condition at discharge and cosmesis.Results: There was no statistically significant difference between the two groups with respect to the parameters like postoperative pain, hospital stay and complication profile. However, operative time for SILS appendectomy were found to be significantly higher compared to conventional group.Conclusions: Single incision laparoscopic appendectomy using standard laparoscopic instruments is safe and effective, feasible surgery with better cosmetic results.


2020 ◽  
Vol 7 (8) ◽  
pp. 2714
Author(s):  
Srikant Patro ◽  
Ashish K. Sahoo ◽  
Nikhil Muduli ◽  
Ashish K. Mishra ◽  
Tapan Kumar ◽  
...  

Single incision laparoscopic surgery is an emerging branch of minimally assess surgery to reduce scar and post-operative pain. Appendicitis is a common general surgical problem encountered in day to day practice. Different methods of appendectomy have been described by different surgeons from open to laparoscopic and now single incision laparoscopic surgery has been practised. This is a prospective study carried out in our Department of General Surgery SCB Medical College, Cuttack from February 2019 to March 2020; 60 patients had undergone the procedure and the results are published noted under headings of post-operative pain at (6 hours, 12 hours, 24 hours and 48 hours), post-operative requirement of analgesia (diclofenac) at (6 hours, 12 hours, 24 hours and 48 hours), operative time, days to resume bowel activity, days of hospital stay, post-operative complication in accordance to Clavien-Dindo classification.


2011 ◽  
Vol 1 (1) ◽  
pp. 18
Author(s):  
Simon Blackburn ◽  
Vanessa Chow ◽  
Varadarajan Kalidasan ◽  
Anies Mahomed

We present a 4-year-old girl who underwent a single incision laparoscopic surgery (SILS) heminephrouretectomy. The procedure was completed without intra-operative complications or conversion. The operative time was 162 min. At 3 month follow up there is no evident scar and the patient is asymptomatic. SILS upper moiety heminephrouretectomy for duplex kidney is safe and technically feasible in children.


2015 ◽  
Vol 33 (07) ◽  
pp. 194-201
Author(s):  
B. Vestweber ◽  
E. Straub ◽  
C. Paul ◽  
B. Kaldowski ◽  
A. Rink ◽  
...  

2018 ◽  
Vol 5 (11) ◽  
pp. 3685
Author(s):  
Jawahar K. ◽  
Sharanya R. ◽  
Sanjay Prakash

Background: Single Incision Laparoscopic Surgery (SILS) is a new technique of minimally invasive surgery using a single incision to minimize all ports to one site, hence a single scar that can be strategically placed in the umbilicus for a perceived scar less abdomen.Methods: We report this study evaluating the possible advantages of SILS versus conventional laparoscopic appendectomy through a randomized controlled trial. The study population includes patients diagnosed as acute appendicitis. A total of 50 patients underwent appendectomy, patients were randomly assigned to either SILS appendectomy or conventional appendectomy in 1:1 ratio. Primary end points were operative time, complication rate, postoperative pain, post-operative hospital stay and patient satisfaction.Results: The pain scores measured at 48 hours were significantly lower in SILS group than conventional Lap appendectomy group. Patients had significant satisfaction score and lower pain score in SILS group than Lap appendectomy group measured at 6 weeks after appendectomy. However, the post-operative stay was similar in both the groups. There was no conversion to open appendectomy in both the groups. Patient satisfaction score in SILA was found to be higher than CLA. Operating times were similar and post-operative stay was apparently lower.Conclusions: SIL appendectomy is as safe and effective as conventional lap appendectomy.


2021 ◽  
pp. 5-10
Author(s):  
O. V. Galimov ◽  
E. N. Prazdnikov ◽  
V. O. Khanov ◽  
D. O. Galimov

Aim. To identify a perspectives for using a single incision laparoscopic technologies in surgery.Materials and methods: Today we have a several questions relating to a single incision laparoscopic surgery such as the possible spectrum of their application, safety and economic efficiency. The main is: does this technologies have a perspectives in future.In paper was performed a retro and prospective analysis of the data of modern literature and authors own experience in surgical treatment using a single incision laparoscopic technologies.Results: The study included 74 patients who underwent: cholecystectomy – 64 (86,5%), nephrectomy – 4 (5,4%), ovarian cyst removal – 4 (5,4%), kidney resection – 2 (2,7 %), using various kind of ports: “X-Cone Karl Storz” (28), “Covidien” (18), “PPP” (7), and 21 cases of multi-trocar access.Conclusions: Our opinion that the perspectives for the development of single incision laparoscopy, is the further development of endoscopic devices, including robotic ones, and we believe that it will be a real future and endoscopic surgeons should be ready for this.


Sign in / Sign up

Export Citation Format

Share Document