Single-port laparoscopic surgery: an overview

As innovation continues to move 21st century surgery forward, one of the emerging concepts is single-port or single-incision laparoscopic surgery. The fundamental idea is to have all of the laparoscopic working ports entering the abdominal wall through the same incision. The major drawback to such a surgical approach is that the concept of ‘‘triangulation’’ to which laparoscopic surgeons have grown accustomed in terms of both the instruments and scope is lacking. This, however, seems to be overshadowed by the increasing acceptability of in-line viewing, with the reemphasis on surgeons performing flexible endoscopy and on newer ideas such as natural orifice translumenal endoscopic surgery (NOTES). This very paradigm shift has energized both surgeons and industry to research important issues and develop new technology to make concepts such as single-port laparoscopic surgery become a reality. As part of the effort put forth by the technology committee of the Society of Gastrointestinal and Endoscopic Surgeons (SAGES) to inform surgeons about cutting edge technology, this article is published both to clarify understanding of the single-port laparoscopic surgery concept and to categorize the currently available tools and techniques.