Single Incision Multiport Laparoscopic Surgery (SILS) with Conventional Instruments: A Single Centre Experience

Background: Single incision laparoscopic surgery (SILS) is an evolving field. Specially designed ports required for SILS are expensive, making this technique unaffordable to many. To overcome this drawback, the use of conventional affordable instruments for SILS was encouraged. We present our case series of SILS with conventional instruments in a tertiary care centre. Methods: This is a single centre pilot study of 30 consecutive cases operated by SILS using conventional laparoscopic instruments. Outcomes measured were operative time, post-operative pain by Visual analogue scale (VAS), resumption of oral diet, duration of stay in the hospital, wound cosmesis and complications. Results: Thirty patients (21 females and nine males; mean age 35.05 ± 12.06 years) were operated by SILS procedure. Twenty single incision laparoscopic Cholecystectomies(SILC), seven single incision laparoscopic appendectomies (SILA) and three single incision diagnostic laparoscopies(SIDL) were done with average operative time of 92 minutes, 47 minutes and 53 minutes respectively. All surgeries were performed successfully without conversion to conventional laparoscopy or open method. Majority patients were given oral feeds and discharged on the second postoperative day without any complications. Wound cosmesis was satisfactory with an inconspicuous scar in all patients. Conclusion: Our initial experience of using conventional laparoscopic instruments for SILS demonstrates its feasibility and utility especially in resource challenged settings. The advantage of SILS is its reduced need of analgesics and better wound cosmesis, without significant post-operative complications.