Does single-port surgery allow for the use of three channels that can admit a scope and two instruments? Is abdominal trauma further minimized using an natural orifice such as the umbilicus? Will the procedure becomes less challenging with improved flexible instruments?
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Cleveland—Surgeons at the Cleveland Clinic’s Glickman Urological & Kidney Institute have taken laparoscopic surgery to the next level by performing a series of surgeries requiring only a single abdominal incision. Using a device newly listed by the FDA, Jihad H. Kaouk, MD, and colleagues say the single-port procedures leave little to no scarring and reduce postoperative complications…
To date, Dr. Kaouk’s team has used the single-port technique to perform renal cryoablation, sacrocolpopexy, simple nephrectomy, wedge renal biopsy, and pediatric varicocelectomy…
The surgery is performed through a 1.5-cm semicircular incision in the inner curve of the umbilicus, and the rectus fascia is incised. The recently introduced single port with multiple channels (Uni-X Single-Port Laparoscopic System, Pnavel Systems, Inc., Cleveland) is inserted and fixed with sutures to the skin. After achieving pneumoperitoneum at 15 mm Hg, a 5-mm scope with a flexible tip (EndoEYE, Olympus Surgical, Orangeburg, NY) is inserted, and special curved in-struments as well as flexible instruments are used. Procedures are performed duplicating traditional laparoscopic steps, Dr. Kaouk said…
With more than 25 cases completed as of this writing, Dr. Kaouk said there had been no complications, no conversion to standard laparoscopy, and no addition of ports. The initial experience with the technique will be presented by Dr. Kaouk and colleagues at the AUA annual meeting in May.