Single-incision laparoscopic surgery launched at Saint Louis University Hospital

Saint Louis University Hospital recently launched a new surgical program - single-incision laparoscopic surgery - which is a critical advancement in minimally-invasive surgery, paving the way for natural orifice surgery.

Led by Ovunc Bardakcioglu, M.D., a gastrointestinal surgeon at SLU Hospital, the single-incision surgery team has already performed a number of gastrointestinal (GI) procedures, including appendectomies, gall bladder removals and, most recently, colectomies. In fact, SLU Hospital's program is one of only a few to perform a single-incision laparoscopic colectomy for colorectal cancer. This incredibly challenging procedure is the latest advancement in minimally-invasive colorectal surgery.

"The single-incision procedure is revolutionary in the gastrointestinal surgical field," says Dr. Bardakcioglu. "As researchers and physicians, we are always looking for the most effective and least invasive techniques to benefit our patients. Single-incision laparoscopic surgery may soon become the preferred method of the future."

Previously, GI patients had only two surgical options: conventional open surgery or laparoscopic with multiple incisions. In most cases, doctors and patients prefer the laparoscopic method over open surgery. However, unlike traditional laparoscopic surgery, single-incision laparoscopic surgery requires only a small incision (approximately one-half inch) in the bellybutton. As a result, the patient experiences less pain and quicker recovery. Patients also enjoy the aesthetic benefit of fewer visible post-operative scars.

Single-incision surgery involves the use of a flexible scope and instruments that can easily move around inside the body and produce images from almost every angle. Additionally, the instrument provides surgeons with a larger field of view and helps them avoid situations where the tips of different instruments collide in smaller spaces during the operation.

Single-incision surgery represents an important step for minimally-invasive surgical procedures. Ultimately, this innovative method may be the first step in the use of traditional flexible endoscopes in minimally-invasive surgery by using natural orifices of the human body as entry points. Currently, three different routes to the peritoneal cavity are being investigated: transgastric, transvaginal and transcolonic.

"There is still much work to be done, which is why a number of GI surgeons in the area have collaborated to evaluate and investigate potential single-incision surgical options," says Dr. Bardakgioclu. "By exchanging ideas and teaching one another, we are working to provide the best possible care for our patients and eventually make pure natural orifice surgery a clinical reality."

The opportunity to develop, launch and lead a single-incision surgery program is what brought Dr. Bardakcioglu to SLU Hospital in January 2008. Double board-certified in colorectal and general surgery, Dr. Bardakcioglu trained as a resident in general surgery at Beth Israel Medical Center in New York City and completed his fellowship in colon and rectal surgery at Cedars-Sinai Medical Center in Los Angeles. His profound interest in teaching and practicing advanced medicine makes him well-suited in his role as a GI surgeon at SLU Hospital.

"As a distinguished research and academic institution, SLU Hospital's interest and strong commitment to advanced medicine is unparalleled," says Dr. Bardakcioglu. "The hospital has provided me with the resources and opportunities that I need to practice and teach quality healthcare for the betterment of the greater community."

Dr. Bardakcioglu is scheduled to lead courses on single-incision surgery for surgeons in the region. The first local course will be in May 2009 and features single-incision appendectomies. A national course is scheduled for June 2009 and will focus on the single-incision colectomy and other advances in minimally-invasive colorectal surgery. These are the first of many courses that he hopes to teach for those GI surgeons interested in learning new minimally-invasive surgical techniques.