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Lectures on Single Port Surgery

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General and digestive > Gallbladder > Cholelithiasis > Cholecystectomy with one port

Professor D Mutter (France)

December 2011
English - 12'10''

Laparoscopic cholecystectomy is now accepted as the gold standard for the treatment of symptomatic cholelithiasis. Traditionally, laparoscopic cholecystectomy has been performed with four ports either using the American or the French technique. There has been a trend toward minimizing the number of incisions and ports required. The development of various ports allows the introduction of multiple instruments through a single port inserted at the umbilicus. This has made single port laparoscopy feasible. In this lecture, Professor Didier Mutter details all aspects learned from his experience.


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table of contents

00'13'' Evolution of abdominal surgery
00'17'' Single port surgery: problems to solve
00'32'' Single port surgery access
01'31'' Triport / Quadriport
01'50'' GelPort system
02'28'' Quadraport
03'19'' SILS Covidien
04'05'' X-Cone Karl Storz
04'44'' Single port surgery: the ideal port?
05'24'' Instrumentation
06'10'' Problem of exposure
06'40'' Exposure tricks
09'22'' Conversion to conventional laparoscopy
10'50'' Single port surgery: limitations
11'12'' Single port surgery: experience/learning curve
11'40'' Conclusions
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General and digestive > Colon

Professor L Boni (Italy)

January 2011
English - 13'54''

In this lecture, Dr. Luigi Boni discusses single port colonic resection, and shows his technique by video demonstration and the results of his experience.


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table of contents

00'10'' Our experience in Varese, Italy
00'44'' Single port surgery
01'04'' Principles
01'31'' Single port right colectomy
04'04'' Exposure
05'47'' Dissection
07'58'' Right colon mobilization
08'56'' Specimen extraction
09'51'' Immediate and distant results
12'14'' Conclusions
13'21'' Single port colectomy: worldwide experience

Single port, colon resection

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General and digestive > Stomach and duodenum

Doctor H Weiss (Austria)

January 2011
English - 9'32''

Laparoscopic fundoplication is the actual gold standard for the surgical treatment of gastroesophageal reflux. In this lecture, Dr. Helmut Weiss shows a single port laparoscopic fundoplication, presents his experience and also shows how new instruments can help the surgeon in single port surgery.


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table of contents

00'08'' Background
01'16'' Patients and methods
02'45'' SIL procedures
03'06'' Technique
06'35'' Results
09'21'' Conclusion

laparoscopy, GERD, single port, fundoplication, single incision

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Robotic surgery

Doctor P Allemann (Switzerland)

October 2010
English - 7'02''

The great problem of single access surgery is the conflict of instruments and the lack of triangulation. In this lecture, Dr. Pierre Allemann shows how we can remedy this technical problem using robotics.


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table of contents

00'20'' Ergonomics
02'49'' Use of robotics
03'51'' Inverted control of instruments
04'45'' Robotic single trocar Nissen fundoplication
06'53'' Conclusion
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General and digestive

Doctor EM Targarona (Spain)

October 2010
English - 9'08''

In this lecture, Professor Eduardo Targarona presents the early results of Single Incision Laparoscopic Surgery for appendectomy, adrenalectomy, hernia repair and applications in liver surgery.


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table of contents

00'28'' Levels of evidence and grades of recommendation
00'56'' Appendectomy
03'25'' Adrenal surgery
07'17'' Hernia surgery
08'37'' Conclusions
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NOTES > Human application

Doctor B Dunkin (United States)

June 2010
English - 17'36''

In recent times, innovative techniques of Natural Orifice Transluminal Endoscopic Surgery (NOTES) and Single Incision Laparoscopic Surgery (SILS) have been applied as a step towards even more less invasive procedures. In this lecture, Doctor Brian Dunkin presents a critical review of all aspects of these two techniques and of the so-called LESS (Laparo-Endoscopic Single sight Surgery).


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table of contents

00'19'' Overview
00'57'' LESS: Laparo-Endoscopic Single sight Surgery
01'46'' Goal of minally invasive surgery
03'33'' Concerns about LESS
05'07'' LESS and hernia
06'33'' LESS and safety
08'13'' LESS and wound complications / pain
08'55'' Concerns about LESS
09'27'' NOTES and safety
11'03'' Patients not ready for NOTES?
12'26'' Patients trust us!!!
13'33'' Goals of MIS
14'45'' Benefits of NOTES
15'27'' Timeline of Laparoscopic Cholecystectomy
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General and digestive > Gallbladder > Cholelithiasis > Cholecystectomy with one port

Doctor S Morales-Conde (Spain)

April 2010
English - 20'27''

Currently surgeons try to improve the results of standard laparoscopic surgery. Single port access seems to be a feasible technique. In this lecture, Doctor Morales Conde presents his experience in single port cholecystectomy and abdominal wall surgery.


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table of contents

00'07'' Introduction
03'15'' Inconvenients
05'08'' Solutions
09'29'' Objectives
09'48'' Inguinal hernia - TEP
15'43'' Ventral hernia - double crown
19'58'' Conclusions
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Endocrine surgery > Adrenal glands > Tumor > Single port adrenalectomy

Professor M Walz (Germany)

April 2010
English - 18'48''

Minimally invasive adrenalectomy is the gold standard in adrenal surgery. In this lecture, Doctor Walz presents an evolution of his retroperitoneoscopic adrenalectomy presenting the technical details and the operative procedure of a single access retroperitoneoscopic adrenalectomy (SARA).


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table of contents

00'07'' Introduction
01'36'' Posterior retroperitoneoscopic approach
03'52'' Evolution of procedures
05'08'' Single access retroperitoneoscopic adrenalectomy
10'23'' Second paper
12'20'' Cosmesis
13'49'' Recent developments
16'27'' Recent developments 2
17'45'' Conclusion
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General and digestive > Appendix > Appendicitis > Laparoscopic appendectomy

Doctor G Dapri (Belgium)

February 2010
English - 21'26''

Single Incision Laparoscopic Surgery (SILS) has the potential advantages of reduced postoperative pain and reduced port-site complications. In this lecture, Dr. Giovanni Dapri presents new curved instruments for single access laparoscopic surgery and shows the feasibility of this approach for appendectomy and cholecystectomy in selected cases.


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table of contents

00'07'' Introduction
01'00'' Instruments
04'08'' S-Access transumbilical lap appendectomy
10'03'' Persisting problems and outcomes
11'38'' S-Access transumbilical lap cholecystectomy
18'17'' Persisting problems and outcomes
20'45'' Conclusions
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Pediatric surgery

Doctor T Ponsky (United States)

February 2010
English - 21'18''

Single Incision Laparoscopic Surgery (SILS) is feasible for a variety of adult and pediatric general surgical conditions, allowing for scarless abdominal operations. In this lecture, Dr. Todd Ponsky presents all the technical aspects of this approach demonstrating the types of trocars, systems and instruments with video demonstrations.


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table of contents

00'46'' Single site surgery
01'21'' Drawbacks?
02'03'' How to operate from a single site?
02'15'' Trocars
02'32'' Modified trocars
05'02'' Covidien SILS trocar
05'54'' Multiple trocars
06'09'' Technique
07'43'' Hand instruments
10'33'' Laparoscopes
14'09'' Economics
15'46'' Reusable ports
15'57'' Reusable bent instruments
16'31'' Single port cholecystectomy in resident training: a reproducible technique
21'17'' Conclusion
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General and digestive > Colon

Professor J Leroy (France), Professor J Marescaux (France)

January 2010
English - 12'40''

Trans-Umbilical Laparoscopic Surgery (TULS) seems to be feasible and safe even using conventional laparoscopic instruments for simple procedures. In this lecture, Prof. Joel Leroy presents a trans-umbilical laparoscopic sigmoidectomy showing the types of port and instruments used.


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table of contents

00'37'' Introduction
01'52'' TULS sigmoidectomy
07'24'' Sigmoid specimen removal
09'04'' Transumbilical extraction
09'12'' Transanal extraction
10'44'' Tricks to improve the surgical skill in TULS
10'52'' Use of robotics
11'37'' Double curved instruments
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Doctor A Patel (United Kingdom)

December 2009
English - 11'55''

Currently, there are no reports in the literature regarding single incision hepato-pancreato-biliary surgery. In this lecture, Dr. Ameet Patel presents his experience in performing SILS cholecystectomy and cholangiography, and shows a video of a SILS non-anatomical liver resection of segment II-III.


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table of contents

00'19'' Literature review
00'50'' SILS: our experience
01'57'' SILS cholecystectomy and cholangiogram: aims
02'16'' SILS cholecystectomy and cholangiogram: methods
02'28'' SILS cholecystectomy and cholangiogram: results
03'13'' SILS cholecystectomy and cholangiogram: any benefits?
03'54'' SILS HPB: what's next?
04'09'' SILS HPB: left lateral liver resection
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General and digestive > Stomach and duodenum > Morbid obesity > Laparoscopic sleeve gastrectomy

Doctor M Vix (France)

December 2009
English - 5'31''

In this lecture, Dr. Michel Vix presents the video of a one trocar sleeve gastrectomy using the SILS port by Covidien. The procedure respects all steps of the conventional laparoscopic approach. Note that there is no crossing of instruments; of particular interest is the running suture performed with the Endostitch device too.


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table of contents

00'07'' Port placement
00'39'' Exposure and dissection
02'30'' Division of the fundus
04'23'' Specimen extraction and stitching
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NOTES > Concepts and philosophy

Doctor P Allemann (Switzerland)

June 2009
English - 6'20''

The advantages of single access surgery are known, but many disadvantages need to be overcome. In this lecture, Dr. Pierre Allemann discusses these arguments and presents an experimental robotic single port Nissen fundoplication.


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table of contents

00'08'' Background
01'04'' External conflicts
02'41'' Inverted control of instruments
03'18'' Robotic single port Nissen fundoplication
04'52'' Conclusion

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