Tek İnsizyon Laparoskopik Apendektomi (SILA)
Özet
Bu bölüm, tek insizyon laparoskopik apendektomi (SILA) yöntemini ve avantajlarını ele almaktadır. Akut apandisit, yaygın bir abdominal cerrahi acili olup, laparoskopik apendektomi, açık cerrahiye göre daha az ağrı, daha iyi kozmetik sonuçlar ve kısa hastanede kalış süresi sağladığı için tercih edilmektedir. SILA, 1983’ten beri uygulanan bir tekniktir ve tek kesiyle yapıldığında yara yeri enfeksiyonunu azaltmakta, postoperatif iyileşmeyi hızlandırmaktadır.
SILA’da, umblikal bölgeden tek bir kesi ile girilir ve bu kesi üzerinden üç farklı aletle apendektomi gerçekleştirilir. Bu yöntem, minimal invaziv cerrahinin prensiplerine dayanarak geliştirilmiştir. Araştırmalar, SILA’nın daha iyi kozmetik sonuçlar ve düşük ağrı skoru sunduğunu göstermektedir; ancak teknik zorluklar ve yüksek maliyet gibi dezavantajları da bulunmaktadır.
SILA, obez hastalar için de uygun olup, komplikasyon oranları normal kilolu hastalarla benzer seviyelerde bulunmuştur. Genel olarak, SILA, laparoskopik apendektomiye alternatif olarak değerlendirilebilir, ancak cerrahların deneyim kazandıkça zorlukların azalması beklenmektedir.
This section discusses the single incision laparoscopic appendectomy (SILA) method and its advantages. Acute appendicitis is a common abdominal surgical emergency, and laparoscopic appendectomy is preferred over open surgery due to less pain, better cosmetic results, and shorter hospital stays. SILA has been used since 1983, and performing the surgery through a single incision reduces the risk of wound infections and accelerates postoperative recovery.
In SILA, access is gained through a single incision in the umbilical region, and the appendectomy is performed using three different instruments through this incision. This method is developed based on the principles of minimal invasive surgery. Research shows that SILA offers better cosmetic results and lower pain scores; however, it also has disadvantages, such as technical challenges and higher costs.
SILA is suitable for obese patients as well, with complication rates similar to those of normal-weight patients. Overall, SILA can be considered an alternative to laparoscopic appendectomy, but it is expected that as surgeons gain more experience, the challenges will decrease.
Referanslar
Moris D, Paulson EK, Pappas TN. Diagnosis and Management of Acute Appendicitis in Adults: A Review. JAMA. 2021;326(22):2299–2311. doi:10.1001/jama.2021.20502
Chamberlein RS, Sakpal SV: A coprehensive Review of SingleIncision Laparoscopic Surgery (SILS) and Natural Orifice Transluminal Endoscopic Surgery (NOTES) Techniques for Cholecystectomy. J Gastrointest Surg 2009; 13: 1733-1740.
Rispoli G, Armellino MF, Esposito C. One-trocar appendectomy. Surg Endosc 2002; 16: 833-5.
Van den Boezem PB, Kruyt PM, Cuesta MA, Sietses C. Single-incision versus conventional laparoscopic cholecystectomy: a case control study. Acta Chir Belg 2012; 112: 374-7.
Vatansev C, Ece I. Single incision laparoscopic splenectomy with double port. Surg Laparosc Endosc Percutan Tech 2009; 19: 225-7.
Park JH, Hyun KH, Park CH, Choi SY, Choi WH, Kim DJ, et al. Laparoscopic vs transumbilical single-port laparoscopic appendectomy: results of prospective randomized trial. J Korean Surg Soc 2010;78:213-218.
Semm K. Endoscopic appendectomy. Endoscopy 1983; 15: 59-64
S.Ü. Tıp Fakültesi Dergisi Cilt:11 Sayı:1 Sayfa:43-46
Pelosi MA, Pelosi MA III (1992) Laparoscopic appendectomy using a single umbilical puncture (minilaparoscopy). J Reprod Med 37:588–594
Shawn D. St. Peter et al. Single Incision Versus Standard 3-Port Laparoscopic Appendectomy A Prospective Randomized Trial. Ann Surg 2011;254:586–590.
Chouillard E, Dache A, Torcivia A et al. Single-incision laparoscopic appendectomy for acute appendicitis: a preliminary experience. Surg Endosc 2010; 24: 1,861–1,865.
Valla J et al (1999) Umbilical one-puncture laparoscopicassisted appendectomy in children. Surg Endosc 13:83–85
MacDonald ER, Ahmed I. Another step toward scarless surgery. Arch Surg 2009;144(6):593e4
Alptekin H, Yilmaz H, Acar F et al. Incisional hernia rate may increase after single- port cholecystectomy. J Laparoendosc Adv Surg Tech A. 2012 Oct;22(8):731-7. doi: 10.1089/lap.2012.0129. PMID: 23039699.
Casaccia M, Papadia FS, Palombo D et al. Single-Port Versus Conventional Laparoscopic Cholecystectomy: Better Cosmesis at the Price of an Increased Incisional Hernia Rate? J Laparoendosc Adv Surg Tech A. 2019 Sep;29(9):1163-1167.doi:10.1089/lap.2019.0374.
Reibetanz J, Germer CT, Krajinovic K. Single-port cholecystectomy in obese patients: our experience and a review of the literature. Surg Today. 2013 Mar;43(3):255-9.doi:10.1007/s00595-012-0238-1.
Referanslar
Moris D, Paulson EK, Pappas TN. Diagnosis and Management of Acute Appendicitis in Adults: A Review. JAMA. 2021;326(22):2299–2311. doi:10.1001/jama.2021.20502
Chamberlein RS, Sakpal SV: A coprehensive Review of SingleIncision Laparoscopic Surgery (SILS) and Natural Orifice Transluminal Endoscopic Surgery (NOTES) Techniques for Cholecystectomy. J Gastrointest Surg 2009; 13: 1733-1740.
Rispoli G, Armellino MF, Esposito C. One-trocar appendectomy. Surg Endosc 2002; 16: 833-5.
Van den Boezem PB, Kruyt PM, Cuesta MA, Sietses C. Single-incision versus conventional laparoscopic cholecystectomy: a case control study. Acta Chir Belg 2012; 112: 374-7.
Vatansev C, Ece I. Single incision laparoscopic splenectomy with double port. Surg Laparosc Endosc Percutan Tech 2009; 19: 225-7.
Park JH, Hyun KH, Park CH, Choi SY, Choi WH, Kim DJ, et al. Laparoscopic vs transumbilical single-port laparoscopic appendectomy: results of prospective randomized trial. J Korean Surg Soc 2010;78:213-218.
Semm K. Endoscopic appendectomy. Endoscopy 1983; 15: 59-64
S.Ü. Tıp Fakültesi Dergisi Cilt:11 Sayı:1 Sayfa:43-46
Pelosi MA, Pelosi MA III (1992) Laparoscopic appendectomy using a single umbilical puncture (minilaparoscopy). J Reprod Med 37:588–594
Shawn D. St. Peter et al. Single Incision Versus Standard 3-Port Laparoscopic Appendectomy A Prospective Randomized Trial. Ann Surg 2011;254:586–590.
Chouillard E, Dache A, Torcivia A et al. Single-incision laparoscopic appendectomy for acute appendicitis: a preliminary experience. Surg Endosc 2010; 24: 1,861–1,865.
Valla J et al (1999) Umbilical one-puncture laparoscopicassisted appendectomy in children. Surg Endosc 13:83–85
MacDonald ER, Ahmed I. Another step toward scarless surgery. Arch Surg 2009;144(6):593e4
Alptekin H, Yilmaz H, Acar F et al. Incisional hernia rate may increase after single- port cholecystectomy. J Laparoendosc Adv Surg Tech A. 2012 Oct;22(8):731-7. doi: 10.1089/lap.2012.0129. PMID: 23039699.
Casaccia M, Papadia FS, Palombo D et al. Single-Port Versus Conventional Laparoscopic Cholecystectomy: Better Cosmesis at the Price of an Increased Incisional Hernia Rate? J Laparoendosc Adv Surg Tech A. 2019 Sep;29(9):1163-1167.doi:10.1089/lap.2019.0374.
Reibetanz J, Germer CT, Krajinovic K. Single-port cholecystectomy in obese patients: our experience and a review of the literature. Surg Today. 2013 Mar;43(3):255-9.doi:10.1007/s00595-012-0238-1.
