Weiss H, Mittermair C, Weiss M
Abteilung für Chirurgie, A. ö. Krankenhaus der Barmherzigen Brüder, Kajetanerplatz 1, 5010, Salzburg, Österreich.
Lehrabteilung, Paracelsus Medizinische Universität Salzburg (PMU), Salzburg, Österreich.
Chirurg. 2017 Aug;88(8):669-674. doi: 10.1007/s00104-017-0446-8.
Since the introduction of single incision laparoscopy (SIL), there has been disagreement among professional societies regarding a general recommendation for the use of this minimally invasive method.
Determination of evidence-based advantages of SIL compared to multiport laparoscopy (MPL).
Description of recent technical developments and evaluation of prospective randomized clinical trials and valid meta-analyses with regard to organ-specific procedures. In addition, an expert opinion is provided based on 4209 SIL interventions.
SIL is nowadays applied in all fields of general and visceral surgery. Due to the initial enthusiasm, methodologically weak studies were often published in the literature. Any beneficial effect of SIL on reduced perioperative morbidity is not clearly confirmed, yet. A better cosmetic outcome is either obvious (in SIL liver resections) or nearly unverifiable (in SIL cholecystectomies).
SIL has proven feasible and safe after getting through the learning curve. Scientific evidence is currently insufficient to justify SIL without reservation in particular without the individual technical experience of the surgeon.
自单孔腹腔镜手术(SIL)问世以来,专业协会对于普遍推荐使用这种微创方法存在分歧。
确定SIL相较于多孔腹腔镜手术(MPL)基于证据的优势。
描述近期技术发展,并对特定器官手术的前瞻性随机临床试验和有效的荟萃分析进行评估。此外,基于4209例SIL干预提供专家意见。
如今SIL应用于普通外科和内脏外科的所有领域。由于最初的热情,文献中经常发表方法学上薄弱的研究。SIL对降低围手术期发病率的任何有益作用尚未得到明确证实。更好的美容效果要么很明显(在SIL肝切除术中),要么几乎无法证实(在SIL胆囊切除术中)。
在克服学习曲线后,SIL已被证明是可行且安全的。目前科学证据不足,无法毫无保留地证明SIL的合理性,尤其是在没有外科医生个人技术经验的情况下。