H Weiss1,2,3,4, C Mittermair5,6,7,8, M Weiss5,6,7,8. 1. Abteilung für Chirurgie, A. ö. Krankenhaus der Barmherzigen Brüder, Kajetanerplatz 1, 5010, Salzburg, Österreich. helmut.weiss@bbsalz.at. 2. Lehrabteilung, Paracelsus Medizinische Universität Salzburg (PMU), Salzburg, Österreich. helmut.weiss@bbsalz.at. 3. Lehrabteilung, Medizinische Universität Innsbruck (MUI), Innsbruck, Österreich. helmut.weiss@bbsalz.at. 4. Lehrabteilung, Medizinische Universität Wien (MUW), Wien, Österreich. helmut.weiss@bbsalz.at. 5. Abteilung für Chirurgie, A. ö. Krankenhaus der Barmherzigen Brüder, Kajetanerplatz 1, 5010, Salzburg, Österreich. 6. Lehrabteilung, Paracelsus Medizinische Universität Salzburg (PMU), Salzburg, Österreich. 7. Lehrabteilung, Medizinische Universität Innsbruck (MUI), Innsbruck, Österreich. 8. Lehrabteilung, Medizinische Universität Wien (MUW), Wien, Österreich.
Abstract
BACKGROUND: Since the introduction of single incision laparoscopy (SIL), there has been disagreement among professional societies regarding a general recommendation for the use of this minimally invasive method. OBJECTIVES: Determination of evidence-based advantages of SIL compared to multiport laparoscopy (MPL). MATERIALS AND METHODS: Description of recent technical developments and evaluation of prospective randomized clinical trials and valid meta-analyses with regard to organ-specific procedures. In addition, an expert opinion is provided based on 4209 SIL interventions. RESULTS: SIL is nowadays applied in all fields of general and visceral surgery. Due to the initial enthusiasm, methodologically weak studies were often published in the literature. Any beneficial effect of SIL on reduced perioperative morbidity is not clearly confirmed, yet. A better cosmetic outcome is either obvious (in SIL liver resections) or nearly unverifiable (in SIL cholecystectomies). CONCLUSION: SIL has proven feasible and safe after getting through the learning curve. Scientific evidence is currently insufficient to justify SIL without reservation in particular without the individual technical experience of the surgeon.
BACKGROUND: Since the introduction of single incision laparoscopy (SIL), there has been disagreement among professional societies regarding a general recommendation for the use of this minimally invasive method. OBJECTIVES: Determination of evidence-based advantages of SIL compared to multiport laparoscopy (MPL). MATERIALS AND METHODS: Description of recent technical developments and evaluation of prospective randomized clinical trials and valid meta-analyses with regard to organ-specific procedures. In addition, an expert opinion is provided based on 4209 SIL interventions. RESULTS: SIL is nowadays applied in all fields of general and visceral surgery. Due to the initial enthusiasm, methodologically weak studies were often published in the literature. Any beneficial effect of SIL on reduced perioperative morbidity is not clearly confirmed, yet. A better cosmetic outcome is either obvious (in SIL liver resections) or nearly unverifiable (in SIL cholecystectomies). CONCLUSION: SIL has proven feasible and safe after getting through the learning curve. Scientific evidence is currently insufficient to justify SIL without reservation in particular without the individual technical experience of the surgeon.
Entities:
Keywords:
Complications; Cosmesis; Minimally invasive surgery; Single incision laparoscopy; Visceral surgery
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Authors: Helmut G Weiss; Walter Brunner; Matthias O Biebl; Jan Schirnhofer; Katharina Pimpl; Christof Mittermair; Christian Obrist; Eberhard Brunner; Tobias Hell Journal: Ann Surg Date: 2014-01 Impact factor: 12.969