SILS-Single Incision Laparoscopic Surgery

SILS-Single Incision Laparoscopic Surgery

What is Single Incision Laparoscopic Surgery?

Single-incision laparoscopic surgery is one of the most advanced forms of laparoscopic surgery. It should only be performed by surgeons with vast experience and expertise to carry out the procedure successfully. This newer modality is rapidly evolving with the development of new and sophisticated instruments with better functionality to perform this technique. In this article, Dr Kapil Agrawal explains in detail about SILS or single incision laparoscopic surgery, its indications, benefits, and recommendations for optimal outcomes.

How is Single Incision Laparoscopic Procedure Performed

During this procedure, the patient is comfortably given general anesthesia, ensuring they are completely at ease and pain-free.

• An incision of approximately 2 cm is made inside the belly button or the umbilicus, through which a telescope fitted with a camera is introduced into the abdomen.
• Additionally, two long and thin instruments are introduced for the dissection of the target organ. With the help of these two instruments and the camera system, the entire procedure is carried out.
• The best advantage of this technique is that the scar is completely hidden inside the umbilicus, and the patient has minimal post-operative pain, making recovery faster and smoother.

Commonly Performed Surgeries with SILS

Some of the most common surgeries that SILS can perform include:

• Gallbladder Stone - Removal of gallbladder with stones
• Appendicitis - Appendectomy for inflamed appendix
• Small to Moderate Umbilical and Inguinal Hernia - Hernia repair procedures
• Few Gynecological Procedures - Removal of ovarian cysts, fibroids or uterus
• Laparoscopic Sleeve Gastrectomy - Weight loss surgery

With the advent of better technology and instruments, more procedures can be incorporated which can be performed by this technique.

Advantages of the Single Incision Laparoscopic Surgery

There are significant advantages that single port surgery offers over traditional laparoscopic procedures. Some of the most common advantages offered by this revolutionary procedure include:

Better cosmetic appearance

Since it involves only a single incision, which is also hidden inside the umbilicus or belly button, it gives the best cosmetic appearance postoperatively.

Lower risk of infection

The risk of infection is significantly reduced as a single incision carries out the entire surgery.

Faster recovery

Only a single cut of approximately 2 cm is made, which results in faster recovery compared to traditional multi-port laparoscopy.

Minimal pain

The post-operative pain is tremendously reduced since there is only a single incision.

Fewer painkillers and antibiotics

Single incision laparoscopic surgery is associated with significantly less pain, and hence, the use of analgesics and antibiotics is also reduced.

Who should undergo the SILS procedure?

• Young, unmarried females - Who are conscious about scars
• People who are uncomfortable with even minimal scars - People who are into modelling or having air hostesses or corporate jobs are very conscious about little scars and want to avoid them at any cost.
• People who don't want to disclose anything about their surgery - Especially patients undergoing bariatric or weight loss surgery.
• People who want to get their appendix, gallstones, ovary, or uterus removed - However, if these organs are extremely inflamed or infected, then single-port surgery becomes a contraindication.

Limitations of Single Incision Laparoscopic Surgery

Multiple abdominal surgeries

Single incision laparoscopic surgery is quite difficult to perform in patients who have multiple previous abdominal surgeries. This is due to dense adhesions present in the abdomen due to previous surgery.

Tall people

Single incision laparoscopic surgery is not advisable in very tall patients. This is due to the ergonomics that makes the procedure difficult to carry out.

Very obese patients

Similarly, for patients who are very obese, single-port surgery is quite difficult to carry out. However, a few surgeons do carry out weight loss or bariatric surgeries due to their expertise and experience in severely obese patients.

Inflamed organs

When organs such as gallbladder or appendix are very inflamed or infected, it becomes difficult to carry out the single port surgery because such tissues require more range of motions to carry out the dissection.

Cost of Single Incision Laparoscopic Surgery

SILS procedures are marginally costlier when compared to traditional laparoscopic surgery. The method requires more time, precision, and expertise to perform. The use of disposable and special ports, along with sophisticated instruments, adds to the cost of surgery. So, if you are planning to undergo single port surgery, you must ask your surgeon about the difference in the cost of surgery. However, it is worth spending on single-port surgery as the results are extremely satisfying for the patients.

Single Incision Laparoscopic Surgery vs. Conventional Laparoscopy

| Aspect | Single Incision (SILS) | Conventional Laparoscopy | |--------|------------------------|--------------------------| | Number of Incisions | Only one cut of approximately 2 cm | 3-4 punctures of 5-10mm in size | | Recovery Period | 1-2 days | About 3 weeks | | Scars | Scar completely hidden inside umbilicus (practically scar-free) | Four visible scars | | Port Site Infection Risk | Significantly reduced | Higher risk with multiple ports | | Port Site Hernia Risk | Quite low | Higher risk | | Post-operative Pain | Quite less | More pain due to multiple incisions |

What happens if the SILS procedure cannot be completed?

In 5% to 10% of patients, the single incision procedure may not be completed due to anatomical variations or technical difficulties.

In such patients, an additional port has to be created to complete the procedure. The surgery is thus completed in a conventional laparoscopic manner.

In the rarest cases, the surgery has to be converted into an open surgery. These issues are always discussed with the patients before proceeding with the surgery.

Why choose us for Single Incision Laparoscopic Surgery(SILS)

Highly experienced surgeon

Dr Kapil Agrawal, is well renowned laparoscopic surgeon and has been carrying out single port surgeries for quite a few years. He has been internationally trained at some of the best hospitals and has been carrying out advanced laparoscopic procedures with excellent results.

Empaneled with the best hospitals in NCR

Dr. Kapil Agrawal is performing single port laparoscopic surgeries at some of the best hospitals in Delhi NCR. These hospitals have the best camera systems and highly advanced and sophisticated instruments to carry out the procedure successfully.

A multi-disciplinary team of nutritionists and physicians

At our clinic, we have a team of highly committed nutritionists, endocrinologists, and physicians who leave no stone to make sure you have a smooth recovery following surgery.