Journal of Surgical Simulation 2015; 2: 6 - 11

Published: 09 February 2015


Original article

The effect of different single ports on performance in single-incision laparoscopic surgery

Georgios Pafitanis Sofronis Loizides and Bijendra Patel;
Corresponding author: Georgios Pafitanis, 18 Norfolk Square, W21RS, London, UK. Email:


Aims: In the rapidly advancing world of laparoendoscopic surgery, surgeons are faced with new devices all of which are aimed towards a single access. Various single-access devices are available on the market. Our study aimed to compare the performance of experienced laparoscopic surgeons on validated laparoscopic tasks using five devices within a simulation setting.

Methods: Ten experienced consultant laparoscopic surgeons were recruited after completing a questionnaire and meeting the inclusion criteria of the study. Five different single-access devices were assessed. Each participant performed two validated laparoscopic simulation tasks: peg transfer and pattern cut. All surgeons completed both tasks on all five devices in a randomized order. The performance time and the number of errors and instrument clashes on each task were measured. Statistical analysis was carried out using one-way analysis of variance.

Results: All participants were consultant laparoscopic surgeons with 4–20 years of experience with laparoscopy and fulfilled the selection criteria. One-way analysis of variance revealed no statistically significant differences in performance time (peg transfer, P = 0.306; pattern cut, P = 0.819), number of errors (peg transfer, P = 0.182; pattern cut, P = 0.478) or instrument clashes (peg transfer, P = 0.446; pattern cut, P = 0.061) between the different singe-access devices.

Conclusion: In our study, the laparoscopy experts performed equally well on all five single-access devices within a validated simulation environment. More and larger studies in simulated as well as clinical environments are required to provide further evidence.


Single-incision laparoscopic surgery; laparoendoscopic single-site surgery; instruments; single port; laparoendoscopy;