Therapeutics Advances
Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Apr 21, 2015; 21(15): 4440-4446
Published online Apr 21, 2015. doi: 10.3748/wjg.v21.i15.4440
Technical and instrumental prerequisites for single-port laparoscopic solo surgery: State of art
Say-June Kim, Sang Chul Lee
Say-June Kim, Sang Chul Lee, Department of Surgery, Daejeon St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Daejeon, Seoul 110-758, South Korea
Author contributions: Lee SC designed the study, and finally approved the version to be published; and Kim SJ acquired and analyzed data, and drafted the paper.
Conflict-of-interest: Kim SJ and Lee SC have no conflicts of interest or financial ties to disclose.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Sang Chul Lee, MD, Department of Surgery, Daejeon St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Deaheung-dong 520-2, Joong-gu, Daejeon, Seoul 110-758, South Korea. zambo9@catholic.ac.kr
Telephone: +82-42-2209269 Fax: +82-42-2209565
Received: December 12, 2014
Peer-review started: December 16, 2014
First decision: January 8, 2015
Revised: January 26, 2015
Accepted: February 11, 2015
Article in press: February 11, 2015
Published online: April 21, 2015
Processing time: 128 Days and 17.1 Hours
Abstract

With the aid of advanced surgical techniques and instruments, single-port laparoscopic surgery (SPLS) can be accomplished with just two surgical members: an operator and a camera assistant. Under these circumstances, the reasonable replacement of a human camera assistant by a mechanical camera holder has resulted in a new surgical procedure termed single-port solo surgery (SPSS). In SPSS, the fixation and coordinated movement of a camera held by mechanical devices provides fixed and stable operative images that are under the control of the operator. Therefore, SPSS primarily benefits from the provision of the operator’s eye-to-hand coordination. Because SPSS is an intuitive modification of SPLS, the indications for SPSS are the same as those for SPLS. Though SPSS necessitates more actions than the surgery with a human assistant, these difficulties seem to be easily overcome by the greater provision of static operative images and the need for less lens cleaning and repositioning of the camera. When the operation is expected to be difficult and demanding, the SPSS process could be assisted by the addition of another instrument holder besides the camera holder.

Keywords: Camera holder; Laparoscopy; Single-port laparoscopic surgery; Single-port solo surgery; Solo surgery

Core tip: Solo surgery occurs when one surgeon operates with only a scrub nurse. The use of a mechanical camera holder makes such surgery possible. Solo surgery is particularly useful when it is applied to single-port laparoscopic surgery (SPLS); it is then termed single-port solo surgery (SPSS). SPSS facilitates a better operative environment than does SPLS by allowing fixed and stable images under the operator’s direct control. SPSS indications include SPLS indications, after the technique has been mastered. Moreover, total skin-to-skin SPSS could be easily realized by the extraperitoneal application of a retractor system that facilitates incision making and peritoneal opening.