ความรู้จากแพทย์ศรีพัฒน์

Scarless Technique for Gynecologic Surgery




Dr.Chailert Phongnarisorn

Head of Urogynecology & Pelvic Reconstruction Surgery Division at Chiang Mai University, 

and a staff of Gynecologic Oncology Division at Chiang Mai University.

SD-HA-IMC-113-R-00






What is Single-Incision or Single-Port Laparoscopic Surgery?


    Single-Incision Laparoscopic Surgery (SILS) is surgery that is literally performed through a single incision – or port – in a patient’s navel (umbilicus or belly button). Women ‘s Health Care Center gynecologic surgeon Dr.Chailert Phongnarisorn, MD is among only a handful of surgeons across the Thai nation now performing these procedures.

    Single-Incision Laparoscopic Surgery is a form of minimally invasive surgery. In traditional laparoscopic 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 incisions are made and used as “ports” in which to insert instruments to remove the uterus with or without ovary, for example, or to repair the prolapse of the pelvic organs. Unlike a traditional multi-port laparoscopic approach, SILS leaves only a single small scar. Thus, minimizing the incisional pain associated with the multiple points of entry. Because laparoscopic surgery usually results in fewer complications and a more rapid recovery, patients often can return home the same day.







What are the Advantages and Disadvantages of Single-Incision Laparoscopic Surgery?



    Because it uses only one port, single-incision surgery leaves little to no scarring and may reduce complications that commonly occur after traditional open and even traditional laparoscopic abdominal surgery. Patients are reporting less discomfort and faster recovery compared with those undergoing traditional laparoscopy.

    Umbilical incision 6-8 weeks after single-Incision Hysterectomy (womb removal) leaves little to no scarring (Fig).

    For surgeons, the single-port approach 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.


What Procedures can be Done Using the Single-Incision Approach?


  •     Hysterectomy (removal of the uterus)
  •     Myomectomy (removal of fibroid)
  •     Oophorectomy (removal of an ovary)
  •     Cystectomy (removal of the ovarian cyst)
  •     Salpingectomy (removal of a uterine tube)
  •     Pelvic and/or paraaortic lymphadenectomy (removal of lymph nodes)
  •     Sacrocolpopexy (treatment for pelvic organ prolapse in women)
  •     etc.


Who is a Candidate for Single-Incision Laparoscopic Surgery?


    For certain procedures, patients considered for laparoscopic surgery also may be candidates for a single-port procedure. Patients may not be eligible if they have had multiple major abdominal surgeries or are morbidly obese, as both conditions limit visibility and movement inside the abdomen. If you are interested in making an appointment with a surgeon who performs single-port procedures, please call 053 935830


Who Performs Single-Incision Laparoscopic Surgery at Women’s Health  care Center, Chiang Mai.


    Dr.Chailert Phongnarisorn, Head of Urogynecology & Pelvic Reconstruction Surgery Division at Chiang Mai University, and a staff of Gynecologic Oncology Division at Chiang Mai University, recently performed the first single-incision laparoscopic surgeries for many gynecologic procedures including hysterectomy, oophorectomy, cystectomy, salpingostomy, and surgical removal of the pelvic mass, showing promise that these highly technical procedures can now be performed safely by well-trained surgeon.



    

       Dr. Phongnarisorn also has performed several other single-incision transumbilical surgeries, including radical hysterectomy, complete staging surgery for endometrial cancer, and vaginal prolapse surgery (repair of the vaginal canal) in women with pelvic organ prolapse. At the present time he has performed the greatest number of single-incision laparoscopic surgeries for gynecologic cancers in Thailand.


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