Different tools

In recent years, efforts to reduce post-operative pain, to lower wound related morbidities and to improve cosmetic outcomes have led to the development of single-port laparoscopic surgery (SPLS). This technique, however, is not straightforward. The technical complexity of the procedure results in a significant learning curve, which increases operating room time and mandates specialized equipment. This chapter reviews the various tools, which have been developed and are aimed at overcoming the technical pitfalls of SPLS. Different access devices, cameras, retraction methods and operative instruments can be used in SPLS. Some are commercially available and some are now being used in clinical studies. Some tools were developed especially for SPLS after understanding the special needs for this approach and some are improvisations or adjustments of previously accepted instruments for standard laparoscopic surgery to the novel concept of SPLS. This chapter does not list all of the available instruments on the market, but rather serves as an overview of the principles that should guide surgeons in choosing the tools for SPLS. Optimization of the view, providing with adequate organ retraction and achieving triangulation should be the basis of the surgeon's decision when choosing which tools to use for performing SPLS.