Single port laparoscopy

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Objective: To demonstrate the abdominal wall anatomy necessary to perform a single port laparoscopic procedure. Single port laparoscopic (SPL) surgery has reduced the number of sites required to perform laparoscopic surgery. However, the incision at the umbilicus is larger than conventional laparoscopic surgery.Design: Video presentation of clinical article. The video uses animation and surgical cases to demonstrate the relevant abdominal wall anatomy to establish surgical access for a single site or single port laparoscopy.Result(s): This video demonstrates the regional anatomy pertinent to the anterior abdominal wall, specifically of the umbilicus. The umbilicus is a focal point of fusion of the anterior abdominal wall muscles that allows entry into the peritoneal cavity. For this procedure there are 2 incisions possible, a small midline intra-umbilical one and an omega incision. The video demonstrates each technique. Introduction of a port into this single incision is demonstrated with 2 different trocar systems. These trocar systems show how the limitations of using a single site may be reduced.Conclusion(s): The abdominal wall anatomy is unique at the umbilicus and allows optimal placement of a single trocar to allow laparoscopic surgery. Video is available at http://fertstertforum.com/2012974caravalho/.