**1. Introduction**

There are many nomenclatures and abbreviations found in literatures: SILS, single-incision laparoscopic surgery; LESS, laparo-endoscopic single-site surgery; TUES, trans-umbilical endoscopic single-site surgery; SPA, single portal access; E-NOTES, embryologic natural orifice transluminal endoscopic surgery; SAS, single access surgery; S3, single-site surgery; NOTUS, natural orifice transumbilical surgery; SAVES, single access video endoscopic surgery; and SIPES, single-incision pediatric endoscopic surgery. Cultural changes affected the way of managing patients. It has been over 30 years since the first laparoscopic cholecystectomy. Von Ott inspected the abdominal cavity of pregnant women in 1901. Georg Kelling performed "koelioscopie." Jacobeus published his first report "Laparothorakoskopie." Lukichev in 1983 and Muhe in 1985 performed laparoscopic cholecystectomy in humans [1]. Kalloo performed trans-gastric peritoneoscopy in 2004 [2]. Multiple centers performed NOTES in humans, trans-gastric appendectomy and transvaginal cholecystectomy. Limitations of NOTES technique lead to make SILS to go in parallel with it [3]. The first published report in general surgery

appeared in 1992 with appendectomies [4]. In the same year, D'Alessio described a technique for appendectomy in pediatric patients in which a special port was used at the umbilicus to allow the surgeon to bring the appendix out through the umbilicus to perform an extracorporeal appendectomy [5]. 19% of 166 patients in their series required additional trocars, and 4% required conversion to an open operation. The MOT (MOT) was 35 min with a 7-day return to normal activity, compared with 10 days for those that required additional trocars. SIPES has been introduced in our institute by 2003. Now SIPES is our standard technique for many procedures like cholecystectomy, splenectomy, appendectomy, assisted Mitrofanoff, SIPES hernia repair percutaneous internal ring suturing (PIRS), ovarian cystectomy, and fundoplication since 2011. We have performed around 400 SIPES cases up-to-date.
