Comparison of a single-access glove port with a SILS™ port in a surgical simulator model using MISTELS

Background Recent advances in laparoscopy both in human and veterinary medicine have looked at means of being less invasive by using single-port access surgery as opposed to multiport access surgery. The glove port has gained popularity as a cost-effective alternative to commercially available single-port access devices. The primary aim of this study was to compare the glove port to the SILS™ port in a simulator model using the first two MISTELS (McGill inanimate system for training and evaluation of laparoscopic skills) tasks (peg transfer and pattern cutting). Methods Twenty-two novices were enrolled in this experimental study. Each participant had 60 min to practise both MISTELS tasks using two-port laparoscopy. Thereafter participants performed both tasks using the glove and SILS™ port with scores being calculated based on task completion time and errors. Higher scores were indicative of better performance. Participants were assigned into two groups with the starting order of the single ports being randomly selected. A self-evaluation questionnaire with three questions was completed by each participant after testing, rating each port. Results Significantly (p < 0.05) higher scores were achieved using the glove port compared to the SILS™ port when performing both tasks. The glove port was subjectively evaluated as easier to use with more manoeuvrability of the instruments than the SILS™ port. Implications of the study The glove port’s improved manoeuvrability and ease of use make it a cost-effective alternative to the SILS™ port, for use in single-port laparoscopic veterinary surgery.

Maneuverability of the Scope and Instruments within Three Different Single-Incision Laparoscopic Ports: An Experimental Pilot Study

Single-port access systems (SPASs) are currently used in human and veterinary surgeries. However, they pose technical challenges, such as instrument crowding, intra- and extracorporeal instrument collision, and reduced maneuverability. Studies comparing the maneuverability of the scopes and instruments in different SPASs are lacking. This study aimed to compare the maneuverability of three different SPASs: the Covidien SILS-port, Storz Endocone, and glove port. A clear acrylic box with artificial skin placed at the bottom was used to mimic the abdominal wall and cavity. The three SPASs were placed from below, and a 10-mm endoscope and 5-mm instrument were introduced. A motion analysis system consisting of 18 cameras and motion analysis software were used to track the movement of the endoscope and instrument, to determine the volume of the cone-shaped, three-dimensional figures over which movement was possible, with higher values indicating greater maneuverability. The Mann–Whitney U test was used for the analysis. The maneuverability of the endoscope alone was significantly higher in the glove port system than in the other two SPASs. When inserting an additional instrument, the maneuverability significantly decreased in the SILS-port and Endocone, but not in the glove port. The highest maneuverability overall was found in the glove port.

Laparoendoscopic Two-Site Myomectomy (LETS-M) Using Conventional Laparoscopic Instruments and The Glove-Port Technique

We aim to evaluate the surgical outcome of laparoendoscopic two-site myomectomy (LETS-M). The medical records of 204 women receiving LETS-M in a tertiary referral center, including 183 surgeries performed by the experienced surgeon and 21 surgeries performed by 3 well-supervised trainees were retrospectively reviewed. The age of the participants was 39.3±6.4 years. The mean diameter of the largest myoma was 8.5±2.2 cm. The mean weight of the myomas was 281.1±183.1 g. The operation time was 97.6±40.2 min, and the intraoperative blood loss was 99.3±115.2 mL. There were 3 (1%) cases of excessive blood loss (more than 500 mL) and 2 (1%) of postoperative hematoma. The only significant difference between the experienced surgeon and trainees was the operation time (92.3±32.2 min vs. 141.2±54 min, p<.001), while the myoma number, myoma diameter, myoma weight, and intraoperative blood loss were not significantly different. The operation time did not differ among different myoma locations. In multivariate analysis, virginity, myoma number, more than 2 large myomas, and myoma size were independent variables for longer operation times. No patient experienced any major complications. The result revealed that LETS-M is a minimally invasive surgical method that is safe, effective, and easy to learn for managing uterine myoma.

Result of single-incision laparoscopic cholecystectomy using Glove-Port for gallbladder stone at Viet Tiep University Hospital

Tóm tắt Đặt vấn đề: Đánh giá kết quả phẫu thuật nội soi (PTNS) một lỗ cắt túi mật (TM) sử dụng cổng găng tay điều trị sỏi TM tại Bệnh viện Hữu nghị Việt Tiệp. Phương pháp nghiên cứu: Nghiên cứu tiến cứu 20 người bệnh (NB) sỏi TM được PTNS một lỗ cắt TM từ tháng 10/2018 đến tháng 4/2019. Kết quả: Chỉ định: 19 NB sỏi TM đơn thuần, 1 NB viêm TM cấp. Tất cả NB được PTNS một lỗ thành công, không phải thêm trocar hay chuyển mổ mở. Thời gian phẫu thuật 63,7 ± 26,6 phút. 1 trường hợp tai biến chảy máu giường TM. Đau sau mổ 1,13 ngày, nằm viện sau mổ 5,7 ngày. Không có biến chứng sớm. Kết luận: PTNS một lỗ cắt TM sử dụng cổng găng tay là phương pháp khả thi, an toàn điều trị sỏi TM. Abstract Introduction: Evaluating the outcomes of Single-incision laparoscopic cholecystectomy (SILC) by using glove-port for gallbladder stone at Viet Tiep Hospital. Materials and Methods: Prospective cohort in 20 cases were treated by SILC from 10/2018 to 4/2019. Results: 19 patients with uncomplicated gallbladder stone, one patient with acute cholecystitis were enrolled. SILC was applied successfully in all patients, no more trocars required or convert to open surgery. Surgical duration was 63,7 ± 26,6 min. One bleeding complication from gallbladder bed occurred during the operation. The average of post-operative pain was 1,13 days and hospital lenght stay was 5,7 days. No early complication was observed. Conclusion: SILC by using glove-port is feasible, safe for gallbladder stone. Keywords: Single-incision laparoscopic cholecystectomy, Glove-Port