In recent years, a new pioneering method has been increasingly developing globally. It revolutionizes minimally invasive surgery. This is Single-Incision Laparoscopic Surgery, the surgical method called SILS. Abdominal injury is minimized using this technique, as surgical procedures are performed via a 1.5-2 cm single incision through serving as point of insertion for all dedicated laparoscopic instrumentation. Esthetic results are excellent since even this small incision is performed within the umbilical bed making it practically invisible after a short period of time.
Likewise, the minimally invasive surgery becomes even less invasive, offering -in addition to the excellent esthetic results- a lowering of the pain of additional incisions, less pain due to extra incisions and fewer complications that although they are rare they may occur still related to the surgical wound, e.g. suppuration, hemorrhage, hernias, etc.
This technique also allows the viewing of the entire abdomen because the instrumentation and the laparoscopic camera are inserted via the navel, at the centre of the abdomen. Consequently, two double procedures and interventions can be performed concurrently.
It is, however, a very demanding and technically challenging technique requiring extensive surgical experience in laparoscopic surgery, reduced –port techniques and a long learning curve. Instrumentation and maneuver ergonomy from the surgeon requires high skills and education as these cross each other and make maneuvers more difficult. This is why special instruments provided with crossing curved arms have been manufactured as well as special devices (trocars-ports) facilitating the placement and repositioning of the surgical devices through a single incision.
These procedures are performed globally using the SILS method include practically the entire surgical spectrum (cholecystectomy, appendicectomy, hernia repair, colectomy, splenectomy, bariatric surgery, gastrectomy, gastrostomy, gynecological procedures, etc.). The results of the first large case series are impressive, since this method has results similar to the conventional laparoscopic and open surgery, with lower postoperative pain and complications related to the wound and, naturally, better cosmetic results. Due to the technical specificities, the duration of the procedure is slightly longer than typical laparoscopic surgery and patient selection necessitates adequate preoperative screening.
The first single incision laparoscopic cholecystectomy was described in the 1990s. Currently, surgical operations of low to moderate severity such as cholecystectomy, inguinal hernia repair, umbilical hernia, epigastric hernia, and appendicectomy that are safely performed through a single incision by an adequately experienced surgeon. More complicated procedures are performed at specialized clinics paving the way to a wider based application of this method.