Single port access (SPA) surgery--a 24-month experience.
BACKGROUND
In April 2007, we performed our first single port access (SPA) surgical procedure. Beginning with simple procedures, we progressed to more complex procedures employing modifications of the initial technique.


METHODS
Maintaining our abdominal entry technique through a single incision, typically umbilical, we have now successfully performed cholecystectomies, colon resections, small bowel procedures, liver biopsy, splenectomy, adrenalectomy, and surgery of the gastroesophageal junction.


RESULTS
Two procedures have required additional port sites, none has employed transabdominal sutures, and <5% of all procedures have required articulation. Immediate follow-up demonstrates safe completion of multiple procedures with acceptable outcomes of blood loss and hospital stay. Although initial operative times are extended, a decrease is seen following a learning curve. At 2-year follow-up, two hernias developed at the extended incision for colon extraction.


CONCLUSIONS
With initial procedures performed in April 2007, we now report 24-month follow-up of a novel laparoscopic approach utilizing standard instrumentation. We demonstrate that SPA surgery is an alternative to multiport procedures with proposed initial benefits of decreased number of incisions and improved cosmesis for the patient. Long-term prospective randomized large case series will be necessary to assess pain, recovery, and hernia formation proving advantages, if any, over multiport laparoscopy.
Department of Surgery, College of Medicine, Drexel University, 219 North Broad Street, 10th Floor, Philadelphia, PA 19107, USA.
Erica R
ER
Podolsky
Paul G
PG
Curcillo
D015331:Cohort Studies; D004066:Digestive System Diseases / Q000175:diagnosis / Q000601:surgery*; D016145:Endoscopy, Digestive System / Q000009:adverse effects / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D020706:Laparoscopes; D010535:Laparoscopy / Q000009:adverse effects / Q000379:methods*; D008297:Male; D019060:Minimally Invasive Surgical Procedures / Q000295:instrumentation / Q000379:methods*; D011183:Postoperative Complications / Q000175:diagnosis / Q000453:epidemiology; D018570:Risk Assessment; D013997:Time Factors; D016896:Treatment Outcome; D014472:Umbilicus / Q000601:surgery