SILC Vs TPLC

Post operative pain is an important factor from the point of view of the patient in the surgical technique's success and it is unquestionable that reduced postoperative pain was on of the important factors which allow the popularity and superiority of laparoscopic procedures when compared with open technique.(20) The main difference between SILC and TPLC is the number of abdominal wall incisions (one versus three); and actually a major part of postoperative pain usually results from abdominal trauma (incision). So with the reduction of abdominal incisions we can expect reduced post operative pain which will reflected in a decreased postoperative analgesic requirement when SILC compared with TPLC. The literatures show conflicting results regarding
post operative pain score and analgesic requirements between SILC and TPLC; some studies report a difference (19), others a lack of difference.(10,13,18) Our study revealed no statistically significant difference regarding post operative pain and analgesic requirements (non narcotics and opioid) between both groups. Similar results were previously published.(13,18) On the other hand, a recent study showed statistically significant lower postoperative pain scores and analgesic requirement in SILS group than TPLC and this was explained by single small incision in SILC than those in TPLC.(19) On the contrary, Jung at al. revealed pain score and analgesic requirement were significantly higher in SILS group than conventional laparoscopy.(17) The higher pain score in SILS group was explained by the more tissue trauma caused by single port and limited mobility of instruments causing more damage to the abdominal wall.(21)