Single-Port Laparoscopic Solo Surgery: Technical Aspects and Personal Experience

Lee, Sang Chul

Abstract

Solo surgery is a practice in which a surgeon operates alone, without other surgical member's assistance or cooperation, except for a scrub nurse and an anesthetist. Solo surgery at our institution is facilitated by several equipment, including Lone Star Retractor systems and a passive camera holder. The introduction of single-port laparoscopic surgery (SPLS) has dramatically increased the applicability of solo surgery, because SPLS reduces the number of surgical members participating in the surgery. A shortcoming of laparoscopic surgery is the indirect way of observing and manipulating. Solo surgery effectively eliminates this limitation by enabling operator-driven manipulation of the camera. Solo surgery is particularly advantageous in surgeries that are limited to a single quadrant, such as appendectomy, cholecystectomy, and herniorrhaphy, because they require less adjustment of the camera. However, its indications can be extended to include operations that involve multiple quadrants, such as various types of colectomies including total colectomy. In addition, solo open surgery can be performed with the aid of a larger retractor (i.e., the Bookwalter Retractor system). It appears that solo surgery can be performed by any surgeon who can perform SPLS competently and its indications can be extended, possibly after the development of supporting equipment.