37. Single Incision Laparoscopic Surgery (SILS)

The first cases of laparoscopy at the beginning of the 20^th century were diagnostic laparoscopic procedures performed with a single cystoscope. From 1986 onwards, laparoscopy evolved into an accepted multiport technique due to technological improvements. Once it was established, pioneers developed new operative techniques and strategies, tumbling over each other to minimize incisions. Around the beginning of the 21^st century, Single Incision Laparoscopic Surgery was introduced. Only one incision is made and can be used for the introduction of instruments and for specimen extraction. For many experienced laparoscopic surgeons, the differences between the technique and multiport methods proved to be too cumbersome. As a result, single port laparoscopy is not widely used. Its application depends on individual surgeons and institutions, and preferences for particular procedures. We discuss technical details, ergonomic aspects, and the spectrum of favorable and less favorable indications for single incision laparoscopy.