Skip to main content

Advertisement

SpringerLink
Log in

Single-Incision Laparoscopic Surgery (SILS) in Biliary and Pancreatic Diseases

  • Review Article
  • Published:
Indian Journal of Surgery Aims and scope Submit manuscript

Abstract

Laparoscopic cholecystectomy is the gold standard for gallbladder removal and the most common laparoscopic procedure worldwide. With the advent of laparoscopic surgery and its continuous development, the focus has shifted to ‘scarless’ surgery. In recent times, the innovative technique of single-incision laparoscopic surgery (SILS) has been applied in gallbladder removal and even more complex biliopancreatic procedures to further minimize the invasiveness of the surgery. Newer developments in laparoscopic equipments and instrumentation have helped to further evolve this field of minimally invasive surgery. Literature search was performed using the following online search engines: Google, Medline, PubMed, Cochrane, and the online Springer link library. The terms used for the search were as follows: SILS, LESS, single-incision laparoscopic surgery, single-port laparoscopic surgery, SILS cholecystectomy, and SILS pancreatic surgery. Articles that matched the search criteria were selected and extensively reviewed. Moreover, pertinent information on instrumentation and technology for SILS and LESS was obtained by accessing websites of manufacturers. Although SILS represents the search for an essentially scarless surgery, there is still not a widespread use and uniformity of this procedure. SILS is performed either by single- or multiple-port technique. In the present article, we present a review of the potential benefits, limitations, and risks of SILS in biliary and pancreatic diseases. There are many studies showing benefits in cholecystectomy. A few case reports have also emerged about its feasibility in procedures such as cystogastrostomy and limited pancreatic resection. Further research and development of this technique is needed to arrive at a tangible conclusion about the perceived benefits of SILS. Randomized studies to compare SILS with traditional laparoscopy are essential.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6
Fig. 7
Fig. 8
Fig. 9

Similar content being viewed by others

References

  1. McGregor CG, Sodergren MH, Aslanyan A, Wright VJ, Purkayastha S, Darzi A, Paraskeva P (2011) Evaluating systemic stress response in single port vs. multi-port laparoscopic cholecystectomy. J Gastrointest Surg 15:614–622

    Article  PubMed  Google Scholar 

  2. Vittimberga FJ Jr, Foley DP, Meyers WC, Callery MP (1998) Laparoscopic surgery and the systemic immune response. Ann Surg 227(3):326–334

    Article  PubMed  Google Scholar 

  3. Chamberlain RS, Sakpal SV (2009) A comprehensive review of single incision laparoscopic surgery (SILS) and natural orifice transluminal endoscopic surgery (NOTES) techniques for cholecystectomy. J Gastrointest Surg 13(9):1733–1740

    Article  PubMed  Google Scholar 

  4. Glaser F, Sannwald GA, Buhr HJ, Kuntz C, Mayer H, Klee F et al (1995) General stress response to conventional and laparoscopic cholecystectomy. Ann Surg 221(4):372–380

    Article  PubMed  CAS  Google Scholar 

  5. Keus F, Gooszen HG, Van Laarhoven CJ (2009) Systematic review: open, small-incision or laparoscopic cholecystectomy for symptomatic cholecystolithiasis. Aliment Pharmacol Ther 29(4):359–378

    Article  PubMed  CAS  Google Scholar 

  6. Lau WY, Leow CK, Li AK (1997) History of endoscopic and laparoscopic surgery. World J Surg 21:444–453

    Article  PubMed  CAS  Google Scholar 

  7. Bittner R (2004) The standard of laparoscopic cholecystectomy. Langenbecks Arch Surg 389:157–163

    Article  PubMed  CAS  Google Scholar 

  8. Mühe E (1986) Die erste: cholecystecktomie durch das laparoskop (The first laparoscopic cholecystectomy). Langenbecks Arch Surg 369:804

    Google Scholar 

  9. Kaiser AM, Corman ML (2001) History of laparoscopy. Surg Oncol Clin N Am 10:483–492

    PubMed  CAS  Google Scholar 

  10. Kalloo AN, Singh VK, Jagannath SB, Niiyama H, Hill SL, Vaughn CA, Magee CA, Kantsevoy SV (2004) Flexible transgastric peritoneoscopy: a novel approach to diagnostic and therapeutic interventions in the peritoneal cavity. Gastrointest Endosc 60:114–117

    Article  PubMed  Google Scholar 

  11. Reddy N, Rao P (2004) Per oral transgastric endoscopic appendectomy in humans. Abstract presented at 45th Annual Conference of the Society of Gastrointestinal Endoscopy of India; February 28–29 Jaipur, India

  12. Marescaux J, Dallemagne B, Perretta S, Wattiez A, Mutter D, Coumaros D (2007) Surgery without scars: report of transluminal cholecystectomy in a human being. Arch Surg 142:823–826

    Article  PubMed  Google Scholar 

  13. Pelosi MA, Pelosi MA 3rd (1992) Laparoscopic appendectomy using a single umbilical puncture (minilaparoscopy). J Reprod Med 37:588–594

    PubMed  CAS  Google Scholar 

  14. Navarra G, Pozza E, Occhionorelli S, Carcoforo P, Donini I (1997) One wound laparoscopic cholecystectomy. Br J Surg 84:695

    Article  PubMed  CAS  Google Scholar 

  15. Osborne DA, Alexander G, Boe B, Zervos EE (2006) Laparoscopic cholecystectomy: past, present, and future. Surg Tech Int 15:81–85

    Google Scholar 

  16. Poon CM, Chan KW, Lee DW, Chan KC, Ko CW, Cheung HY et al (2003) Two-port versus four-port laparoscopic cholecystectomy. Surg Endosc 17:1624–1627

    Article  PubMed  CAS  Google Scholar 

  17. Cuesta MA, Berends F, Veenhof AA (2008) The “invisible cholecystectomy”: a transumbilical laparoscopic operation without a scar. Surg Endosc 22:1211–1213

    Article  PubMed  Google Scholar 

  18. Tsimoyiannis EC, Tsimogiannis KE, Pappas-Gogos G, Farantos C, Benetatos N, Mavridou P et al (2010) Different pain scores in single transumbilical incision laparoscopic cholecystectomy versus classic laparoscopic cholecystectomy: a randomized controlled trial. Surg Endosc 24:1842–1848

    Article  PubMed  Google Scholar 

  19. Edwards C, Bradshaw A, Ahearne P, Dematos P, Humble T, Johnson R et al (2010) Single-incision laparoscopic cholecystectomy is feasible: initial experience with 80 cases. Surg Endosc 24:2241–2247

    Article  PubMed  Google Scholar 

  20. Rivas H, Varela E, Scott D (2010) Single-incision laparoscopic cholecystectomy: initial evaluation of a large series of patients. Surg Endosc 24:1403–1412

    Article  PubMed  Google Scholar 

  21. Romanelli JR, Earle DB (2009) Single-port laparoscopic surgery: an overview. Surg Endosc 23:1419–1427

    Article  PubMed  Google Scholar 

  22. Gill IS, Advincula AP, Aron M, Caddedu J, Canes D, Curcillo PG 2nd et al (2010) Consensus statement of the consortium for laparoendoscopic single-site surgery. Surg Endosc 24:762–728

    Article  PubMed  Google Scholar 

  23. Piskun G, Rajpal S (1999) Transumbilical laparoscopic cholecystectomy utilizes no incisions outside the umbilicus. J Laparoendosc Adv Surg Tech A 9:361–364

    Article  PubMed  CAS  Google Scholar 

  24. Gumbs AA, Milone L, Sinha P, Bessler M (2009) Totally transumbilical laparoscopic cholecystectomy. J Gastrointest Surg 13:533–534

    Article  PubMed  Google Scholar 

  25. Rao PP, Bhagwat SM, Rane A, Rao PP (2008) The feasibility of single port laparoscopic cholecystectomy: a pilot study of 20 cases. HPB (Oxford) 10:336–340

    Article  Google Scholar 

  26. Romanelli JR, Mark L, Omotosho PA (2008) Single port laparoscopic cholecystectomy with the TriPort system: a case report. Surg Innov 15:223–228

    Article  PubMed  Google Scholar 

  27. Merchant AM, Cook MW, White BC, Davis SS, Sweeney JF, Lin E (2009) Transumbilical gelport access technique for performing single incision laparoscopic surgery (SILS). J Gastrointest Surg 13:159–162

    Article  PubMed  Google Scholar 

  28. Zhu JF, Hu H, Ma YZ, Xu MZ, Li F (2009) Transumbilical endoscopic surgery: a preliminary clinical report. Surg Endosc 23:813–817

    Article  PubMed  Google Scholar 

  29. Palanivelu C, Rajan PS, Rangarajan M, Parthasarathi R, Senthilnathan P, Praveenraj P (2008) Transumbilical flexible endoscopic cholecystectomy in humans: first feasibility study using a hybrid technique. Endoscopy 40:428–431

    Article  PubMed  CAS  Google Scholar 

  30. Chow A, Purkayastha S, Aziz O, Paraskeva P (2010) Single-incision laparoscopic surgery for cholecystectomy: an evolving technique. Surg Endosc 24:709–714

    Article  PubMed  Google Scholar 

  31. Duron VP, Nicastri GR, Gill PS (2011) Novel technique for a single-incision laparoscopic surgery (SILS) approach to cholecystectomy: single-institution case series. Surg Endosc 25:1666–1671

    Article  PubMed  Google Scholar 

  32. Tian Y, Wu SD, Chen YS, Chen CC (2010) Transumbilical single-incision laparoscopic cholecystojejunostomy using conventional instruments: the first two cases. J Gastrointest Surg 14(9):1429–1433

    Article  PubMed  Google Scholar 

  33. Lutfi R, Jyot B, Rossi M, Jefferson E, Salti G (2010) Hand-sewn cystogastrostomy using the novel single-incision laparoscopy with flexible-tip laparoscope. J Laparoendosc Adv Surg Tech A20(9):761–766

    Google Scholar 

  34. Barbaros U, Sümer A, Demirel T, Karakullukçu N, Batman B, Içscan Y, Sarıçam G, Serin K, Loh WL, Dinççağ A, Mercan S (2010) Single incision laparoscopic pancreas resection for pancreatic metastasis of renal cell carcinoma. JSLS 14(4):566–570

    Article  PubMed  Google Scholar 

  35. Pugliese R, Forgione A, Sansonna F, Ferrari GC, Di Lernia S, Magistro C (2010) Hybrid NOTES transvaginal cholecystectomy: operative and long-term results after 18 cases. Langenbecks Arch Surg 395(3):241–245

    Article  PubMed  Google Scholar 

  36. Basili G, Valdastri P, Pietrasanta D, Mosca I, Simi M, Menciassi A, Dario P, Goletti O (2011) A new magnetic camera robot enabling a multi-instrument procedure in single incision laparoscopic surgery: preliminary experience. Abstracts and Posters. SAGES, Meeting Guide

Download references

Author information

Authors and Affiliations

  1. Institute of Minimal Access, Metabolic & Bariatric Surgery, Max Healthcare Institute Ltd., 1-2, Press Enclave Road, Saket, New Delhi, 110017, India

    A. Sharma, P. Dahiya, R. Khullar, V. Soni, M. Baijal & P. K. Chowbey

Authors
  1. A. Sharma
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. P. Dahiya
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. R. Khullar
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. V. Soni
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. M. Baijal
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. P. K. Chowbey
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to A. Sharma.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Sharma, A., Dahiya, P., Khullar, R. et al. Single-Incision Laparoscopic Surgery (SILS) in Biliary and Pancreatic Diseases. Indian J Surg 74, 13–21 (2012). https://doi.org/10.1007/s12262-011-0372-9

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12262-011-0372-9

Keywords

Search

Navigation