Single-Incision Laparoscopy

Surgical Resection in Abdomen Via One Small Incision:
Innovation Seeks to Improve Patient Experience and Results

Use of laparoscopes for abdominal operations has been a great benefit in surgery. Patients avoid the large incisions necessary for open surgery (and the potential complications from them). And, they heal and recover faster and don't have to live with a large scar. In recent years, this form of minimally invasive surgery has become broadly accepted, popular, and successful with surgeons and their patients.

But laparoscopic surgery, as normally performed, still requires the surgical team to make multiple incisions, through which to insert ports for each of several laparoscopic instruments. Patients must heal from several incisions and are left with small scars from each in the abdominal-pelvic area. What if the surgical team could introduce all of its instruments and conduct all necessary steps of the operation through one small incision that would heal to nearly invisible?

Patients would welcome this improvement, and it's exactly the latest advance in laparoscopy - one used for the first time in Aria's Northeast Philadelphia community by Aria surgical experts:

  • And, in December 2009, an Aria surgical team led by Robin Rosenberg, MD, Head of Aria's Section on Colorectal Surgery, used single-incision laparaoscopy to remove the right half of a patient's colon, as treatment for a precancerous condition. Read more about this surgical case.

Multiple ports in one incision
In single-incision laparoscopic procedures, the surgeon makes a small cut across the patient's navel and uses this opening to place multiple ports, through which to insert a laparoscope and long, thin surgical tools. With external hand controls, the surgeon can bend and direct these small, articulated devices. (The approach is also referred to as transumbilical endoscopic surgery, because of its access through the navel, the site at birth of the umbilical cord attachment.)

Aria's Division of General Surgery has helped to lead the way in its community in offering minimally invasive surgery.
Learn about the many choices it has made available to Aria patients in recent years.
Without needing to place even a finger within the patient's body cavity, the surgeon can use these advanced tools to see, move, manipulate, cut, resect, remove, cauterize, and suture organs and tissue areas. Once the incision of just a couple of inches across the navel heals, it leaves little or no scar.

Special training for new approach

Surgical resection is an important treatment for many abdominal conditions. For many patients, single-incision laparoscopy for these operations could mean a shorter hospital stay, less pain, lower chance of infection, and faster return to normal activities. As with multiple-incision laparoscopy, the single-incision procedure is an advancement that community hospitals have actually helped to lead because of the options and flexibility to quickly bring on improvements that their surgical staffs enjoy.

Standard laparoscopy can be a demanding procedure for the surgeon; likewise, performing this type of surgery through a single incision requires special preparation and capabilities. Experience is essential and it begins with extensive training. Aria surgeons undergo extended training, including at other centers and with equipment manufacturers, to be able to offer the single-incision approach. The operation also requires the latest in laparoscopic equipment.

Aria's Department of Surgery will expand use of the approach to other types of operations in the near future.