Minimally invasive laparoscopic and single-port surgery

What laparoscopy is

Laparoscopy uses a camera and instruments inserted through small incisions to operate inside the abdomen or pelvis. It usually involves general anaesthesia. The specific procedure determines what is treated and how much recovery time may be needed. [1]

What single-port means

Laparoendoscopic single-site surgery, or LESS, brings instrument access through one incision. It differs from laparoscopy using several ports. The aim of treatment still depends on the condition being operated on. [2]

Single-port and robotic surgery describe different things. Single-port refers to access; robotic assistance refers to a system through which the surgeon controls instruments. Robotic systems may use one or several incisions and do not operate autonomously. [2] [3]

How an approach is chosen

The choice depends on the operation, the condition, the person’s health and the team’s experience. In kidney surgery, for example, open, laparoscopic or robotic approaches may be considered. Reducing incisions must not compromise treatment goals. Evidence for single-port surgery has limits and depends on the operation studied. [4]

Potential benefits and risks

For some kidney operations, laparoscopy may offer less pain and a shorter recovery than open surgery. This does not establish that single-port surgery is always better. A laparoscopic operation may still be major surgery. [5]

Risks include bleeding, infection, injury to organs or blood vessels and anaesthetic complications. A change to open surgery may be necessary. The plan should explain these possibilities rather than promise freedom from pain or complications. [5]

Preparation and recovery

Before surgery, ask for instructions about medicines, fasting and help getting home. Do not stop treatment on your own. Discharge, physical activity and return to work depend on the operation and your recovery; there is no single timetable for every laparoscopic procedure. [1] [6]

• Which operation do I need, and what alternatives are available?
• Why is this approach being proposed for me?
• Will the operation use laparoscopic instruments, robotic assistance or both?
• Might additional access or open surgery be needed?
• What care and warning signs should I know about before going home?