Jagiellonian University - Medical College, 2nd Department of General Surgery, Kraków, Poland.
Adv Med Sci. 2011;56(1):18-24. doi: 10.2478/v10039-011-0007-1.
The objective of the modern surgery is not only to perform surgical procedures aiming to improve the health condition of the patient, but whenever possible to use minimally invasive approach and to ensure the satisfying cosmetic result. During the last years we can observe an intense development of surgical technique minimizing the access to peritoneal cavity to just one small incision, most frequently localized in the umbilicus.
MATERIAL/METHODS: Between October 2009 and May 2010 an overall number of 34 laparoscopic procedures through a single abdominal wall incision were performed at the 2nd Department of Surgery, Jagiellonian University, Medical College in Krakow. There were 28 women and 6 men in the study group ranging in age from 19 - 76 years. Among indications for surgery there were: symptomatic gallbladder stones (21 patients), adrenal gland tumours (8 patients), ITP - Immune Thromocytopenic Purpura (2 patients), appendicitis (2 patients) and splenic cyst (one patient).
There were 31 out of 34 procedures completed with pure Single Incision Laparoscopic Surgery (SILS) technique as intended preoperatively without any intraoperative complications. In 3 patients additional trocars were needed for safe continuation of the procedure. There were no intraoperative complications. The mean operating time was 82 minutes ranging from 25 minutes (appendectomy) to 180 minutes (right adrenalectomy). Mean intraoperative blood loss was 0 - 30 ccm.
SILS surgical procedures constitute the next step in the development of minimally invasive surgery. In the hands of experienced surgeon this particular technique may constitute a safe alternative for classical laparoscopy.
现代外科手术的目的不仅在于进行旨在改善患者健康状况的手术操作，而且还在于尽可能采用微创方法，并确保令人满意的美容效果。近年来，我们可以看到手术技术的飞速发展，将进入腹腔的通道最小化到仅一个小切口，最常见的位置在脐部。
材料/方法：2009 年 10 月至 2010 年 5 月，在克拉科夫雅盖隆大学医学院第二外科部共进行了 34 例经单一腹壁切口的腹腔镜手术。研究组包括 28 名女性和 6 名男性，年龄在 19 至 76 岁之间。手术指征包括：有症状的胆囊结石（21 例）、肾上腺肿瘤（8 例）、特发性血小板减少性紫癜（ITP）（2 例）、阑尾炎（2 例）和脾囊肿（1 例）。
34 例手术中有 31 例按照术前计划成功完成了纯单切口腹腔镜手术（SILS）技术，没有任何术中并发症。在 3 例患者中，需要额外的套管针以安全地继续手术。无术中并发症。平均手术时间为 82 分钟，范围从 25 分钟（阑尾切除术）到 180 分钟（右肾上腺切除术）。术中平均出血量为 0 至 30 立方厘米。
SILS 手术是微创外科发展的下一步。在经验丰富的外科医生手中，这种特殊技术可能是经典腹腔镜手术的安全替代方法。
