Single Hole Surgery

 One_SIngle_Incision
SINGLE HOLE SURGERY: AN INTRODUCTION

Over the last two decades or so, single hole surgery has had a major impact in the treatment of many medical conditions ranging from diseased gallbladders, uterus,kidney stones hernia and appendix , to acute spontaneous subdural haematoma etc.

Single Hole Surgery in the simplest sense is an operative procedure where only a single hole of 1-2 cm is required, as opposed to conventional  laparoscopic techniques, that require as many as three to four holes. It is a technique that has paved the way for increased patient care.

ADVANTAGES OF SINGLE HOLE SURGERY
Single hole surgery offers so many advantages over older techniques that it’s no surprise that we at SVH are the natural choice of thousands of patients from around the country and other countries as well.

Single Hole Surgery offers the following advantages over traditional open surgery:
1. Less pain
2. Early discharge (often within one day of the surgery)
3. Early return to work
4. Less risk of wound infection
5. Lesser risk of hernia formation as no muscle is cut
6. Better cosmetic result (as there is no big scar, only multiple small scars)

But perhaps the biggest factor of all is the overall cost of such a surgery, which is much less than traditional surgical techniques.

Advantages of Single Hole Surgery

The success of this technique kept climbing in further years since 1990 and now we are conducting following operations on regular basis 1-2 cm size hole 2-4 cm size hole Cholecystectomy Total Abd. Hysterectomy (upto 36wks size) Appendicectomy Cholecystectomy with Choledocholithotomy Ovarion cystectomy/Myomectomy/ Psedopancreatic Cysto-Gastrostomy Ectopic Pregnancy In nut shell here are some details of Cholecystectomy which I do by Ultraminilap.

1. Only 1-2 cm size SINGLE hole is made in the abdominal wall to enter the abdominal cavity and complete gall bladder along with the stones is removed. The cystic duct and arteries are ligated. All types of diseased gall bladder (except malignant ones) are dealt with this technique succesfully.

2. Post operative pain is minimal due to the minimal trauma given to the patient at the time of operation. Wound related problems (like wound dehescence, infection, postoperative bowel obstruction, incisional hernia etc.) are also negligible because of very small size of the wound operation.

 3. As the gut is not disturbed, the intestines of the pt. starts functioning immediately after the operation and the patient takes oral diet within 4 to 6 hrs after the surgery as the patient is quite comfortable by now. Most of the patients leave the hospital after a overnight day.

 4. Taruma to the patient is less and there is least disturbance to the body physiology, so Diabetics Hypertensive Cardiac & Pts. of geriatric group with other high risk systemic diseases can stand this operation in a better way than the traditional surgery and leparascopic surgery.

 5. No Pneumoparitoneum (Peritoneal gas distension by Carbon Di Oxide gas) is done (this gas has hazardous effects in cardiac, hypertensive, asthmatic and COPD pts so a very close vigil has to be maintained to avoid any disaster) so safer in comparison to Laparascopic procedures.

 6. Pts start routine life within 4-7 days.

 7. If multiple surgeries are required on the same pt. like surgery for gall bladder with Kidneys stone or removal of uterus with gall bladder or removal of appendix with gall bladder etc. they all can be done together easily.

 8. The western counterpart of this surgery Laparascopic Cholecystecystectomy is done by using expensive delicate instruments (Worth approx 15 Lacs Indian money ), while ultraMiniLap needs Simple set of routine surgical Instruments with mild modification (Worth 8-10 thousand only)

 9. Another big difference with LapChole. is that conversion rate into traditional open operation is almost nil with the UltraMiniLap and almost all kinds of patients can be operated by this technique, while in LapChole first there is selection of patient who can be operated by this technique and even after selection there is a conversion rate of approx. 5% into open surgery.

 10. Pneumoperitonium is produced in LapChole which means peritoneal cavity is distended by Carbon Dioxide gas, though the pressure of this gas is maintained within safety limits by the help of electronic machines but in a poor heamodynamic patients even this pressure is unsafe, secondly problems of CO2 gas absorption may have alarming effects over the health of patient-Asthmatic patients, Cardiac patients, Hypertensive patients are poor tolerant of CO2 absorption.

 11. If multiple surgeries are needed then Lap Chole. doesn’t offer the facility while with ultraminilap one can have Gall Bladder removal along with Appendicectomy, Hysterectomy, Hernia repairs, PCNL etc. in same sitting