Single Port Surgery

Single-port surgery, also known as single-incision laparoscopic surgery (SILS), is a minimally invasive technique that allows surgeons to perform complex procedures through just one small cut, often at the belly button. Here is how it works:

• Single incision access — the procedure begins with a single small incision, usually at the navel. Through this, a specially designed port is inserted. This port acts as a channel through which the surgeon can introduce all necessary instruments, including a camera and working tools, without needing multiple incisions.
• Port system — the port is engineered to accommodate several instruments at once, such as graspers, scissors, and electrosurgical tools. Its design allows instruments to move freely within a confined space while maintaining a seal that prevents gas leakage (essential for laparoscopic surgery).
• High-definition visualisation — a high-definition camera inserted through the same port transmits clear, magnified images of the internal anatomy to a monitor. This real-time view is crucial for guiding the surgeon’s movements with accuracy and care.
• Surgical precision — despite the small working area, the surgeon can perform detailed tasks like tissue removal, suturing, or dissection. Specially designed, curved, or articulating instruments help navigate tight spaces and allow for fine-tuned control.
• Robotic assistance (optional) — in some cases, robotic technology is integrated into the procedure. The robotic system offers an enhanced range of motion and precision, especially useful for complex or hard-to-reach surgical sites.
• Expertise required — a single-port surgery presents unique challenges due to instrument crowding and limited triangulation. It requires advanced training and precise coordination to ensure safe and successful outcomes.

Single-port surgery offers numerous advantages over traditional surgical methods, primarily due to its minimally invasive nature and the use of a single incision. The benefits include:

• Minimal scarring — with only one small incision, often hidden within the navel, scarring is significantly reduced, leading to improved cosmetic outcomes.
• Reduced postoperative pain — fewer incisions result in less tissue disruption, which can lead to less pain after the procedure compared to traditional surgery.
• Faster recovery — patients typically experience shorter hospital stays and can resume daily activities more quickly, as the procedure is less invasive and promotes quicker healing.
• Lower risk of infection — a single incision reduces the potential for infections that can occur at multiple surgical sites, which helps improve overall safety.
• Enhanced precision — the use of advanced tools and high-definition cameras provides the surgeon with a clearer view, which helps ensure more precise operations, even in difficult-to-reach areas.
• Improved cosmetic results — because the incision is often made at the navel, there is minimal visible scarring, which is particularly appealing for patients concerned about their appearance post-surgery.

Single-port surgery is a versatile technique used across multiple specialties, offering a less invasive alternative for a range of procedures. By accessing the surgical site through just one incision, it can effectively treat various conditions while minimising scarring and recovery time. Common applications include:

• Ovarian cysts — removal of benign or symptomatic cysts to relieve pain and prevent complications.
• Endometriosis — surgical excision or ablation of endometrial tissue to manage pain and improve fertility outcomes.
• Fibroids — myomectomy to remove uterine fibroids while preserving the uterus, often an option for women planning to conceive.
• Ectopic pregnancy — safe and effective removal of an ectopic pregnancy to protect the patient’s health and future fertility.
• Pelvic adhesions — treatment of scar tissue within the pelvic area to alleviate pain and restore organ function.
• Salpingectomy — removal of a fallopian tube for cases of infection, damage, or ectopic pregnancy.

Not every patient is suited for single-port robotic surgery, even if the condition itself is treatable through this technique. This approach is ideal for women who meet certain anatomical and clinical criteria and are looking for a minimally invasive option with faster recovery and reduced scarring. Your gynaecologist will evaluate several factors to determine if you're a suitable candidate.

You may be eligible if you:

• Have no extensive prior abdominal or pelvic surgeries that may cause severe adhesions.
• Do not have large or deeply infiltrative disease requiring multiple angles of access.
• Are looking for quicker recovery and minimal cosmetic scarring (e.g. via the navel).
• Prefer a minimally invasive option, but are unsuitable for conventional laparoscopy.
• Are medically fit for general anaesthesia and robotic-assisted procedures.
• Have a body mass index (BMI) within a range that allows safe access, clear visibility, and effective instrument movement during the procedure.

This assessment is typically done during your preoperative consultation and imaging. Your gynaecologist will advise if single-port robotic surgery offers the safest and most effective approach in your case.

Single-port surgery is generally safe and well-tolerated, but like any surgical procedure, it carries some risks. Most side effects are mild and temporary, though rare complications can occur depending on the patient’s overall health and surgical complexity. Possible side effects may include:

• Mild pain or bruising around the incision site, usually at the navel.
• Swelling or minor bleeding at the entry point.
• Temporary bloating or gas discomfort, due to the use of carbon dioxide during laparoscopy.
• Infection at the incision site, though this is uncommon with proper care.
• Hernia at the incision site, especially if the opening is larger or not well-closed (rare).
• Instrument crowding or limited movement, which may increase technical difficulty in some cases.
• Conversion to multi-port or open surgery, if unexpected complications arise during the procedure.

Most women recover without significant issues and are able to resume daily activities within a few days. Your surgeon will discuss all potential risks and provide guidance on how to minimise complications after surgery.

If you are scheduled for single-port surgery, here’s what the overall experience typically looks like:

Before the procedure

• You will undergo pre-operative assessments, such as blood tests or imaging, depending on your condition.
• Your doctor will explain the risks, benefits, and expected outcomes specific to your case.
• You may be advised to fast or adjust medications the night before surgery.

During the procedure

• The surgery is performed under general anaesthesia.
• A small incision (usually at the belly button) is made, through which all instruments are inserted.
• The procedure duration varies based on complexity but often takes 1–2 hours.

After the procedure

• You will be moved to recovery for observation as the anaesthesia wears off.
• Most patients experience mild soreness at the incision site but are mobile within hours.
• Hospital stay is usually brief; many go home the same day or within 24 hours.
• You will be given instructions for wound care and activity restrictions (if any).
• A follow-up appointment is scheduled to monitor healing and review results.

Every patient’s recovery journey is slightly different, but single-port surgery is generally well-tolerated with minimal downtime. If you have any concerns about the process, your doctor will walk you through what to expect based on your specific condition and treatment goals.