Laparoscopic Procedure Taken to New Level
By entering a single, small incision through the navel, a Cleveland Clinic surgeon is taking laparoscopic surgery to a new level.
Typically in laparoscopic surgery — also called band-aid or pinhole surgery — a telescopic rod connected to a video camera, or laparoscope, is inserted through a small incision in the abdomen. Three to five additional small cuts are used as “ports” to insert instruments to remove a kidney, for example, or to repair the urinary tract. Patients can often return home the same day.
Cleveland Clinic urological surgeon Jihad H. Kaouk, MD, is now performing these procedures through a single port that holds both the camera and the instruments. Dr. Kaouk is one of a handful of surgeons across the nation, including Cleveland Clinic’s Mihir Desai, MD, who are pioneering single-port laparoscopy. Dr. Kaouk and Dr. Desai are both on staff at the Glickman Urological & Kidney Institute.
Patients are reporting less discomfort and faster recovery compared with those undergoing traditional laparoscopy. “Many patients also like the fact that the belly button hides the incision site,” Dr. Kaouk says.
The surgery is more challenging than traditional laparoscopy because the surgeon has less freedom of movement with all instruments using the same entry point. Specially designed flexible instruments help to overcome that limitation. “For certain procedures, patients considered for laparoscopic surgery may also be candidates for the single-port procedure,” Dr. Kaouk says, “as long as they did not have multiple major surgeries to the abdomen and are not morbidly obese” — conditions that limit visibility and movement inside the abdomen. As the flexible instruments become more refined and readily available and more surgeons become familiar with the procedure, Dr. Kaouk says single-port laparoscopy will become widely available.
This story originally appeared in the Summer 2008 issue of Cleveland Clinic Magazine.
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