SILS - Single Incision Laparoscopic Surgery

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Laparoscopic Surgery Cuts Down On Incisions

Minimally invasive surgery is even more minimal now that doctors at Baylor College of Medicine are using only one incision for some procedures, leaving behind little to no scar.

Instead of making up to four or more incisions in the stomach and abdomen area, only one is made through the belly button.

"This technique has been around for a couple of years. What we are doing now is expanding the types of surgeries for which we can use this method and understanding the benefits in a research setting," said Dr. Vadim Sherman, assistant professor of surgery and director of the Comprehensive Bariatric Surgery Center at BCM.

Belly button

One-incision surgeries use the same type of devices as traditional laparoscopic surgeries. However, instead of making up to four or more incisions in the stomach and abdomen area, only one is made through the belly button.

"The belly button is easy to access regardless of a person's weight and it's centrally located on the body, making it easy to reach many different organs," Sherman said. "The umbilical ring can be slightly expanded, allowing multiple instruments to be inserted at once."

While this technique is safe, the benefits over traditional laparoscopy have not yet been defined, other than doctor and patient word of mouth. Sherman and his colleagues are detailing all aspects of one-incision surgeries from how it affects surgery time for different conditions, to recovery issues such as healing and pain.

Less scarring

"We are also looking at how we can redesign, if necessary, the tools we use for this procedure," Sherman said. "From my patient's reaction, it seems the recovery process is equivalent to or better than the regular laparoscopic surgery."

The most obvious benefit is less scarring. While there may be a scar left behind, it is located in the belly button and is usually hidden.

Sherman has used this technique to remove appendixes, gallbladders, feeding tubes and, more recently, some obstetrical-related surgeries. He is also adapting the techniques to certain weight loss procedures.

"While this is becoming a more commonly used surgery technique, our goal is to make sure we evaluate and review all aspects to continue to improve upon patient care," Sherman said.



On The Web: Baylor College of Medicine - Houston, Texas
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Bariatrics The branch of medicine that deals with the causes, prevention, and treatment of obesity. The term bariatrics was created around 1965, from the Greek root baro ("weight," as in barometer), suffix -iatr ("treatment," as in pediatrics), and suffix -ic ("pertaining to"). Besides the pharmacotherapy of obesity, it is concerned with obesity surgery.

Laparoscopy Laparoscopic surgery, also called minimally invasive surgery is a modern surgical technique in which operations in the abdomen are performed through small incisions as compared to larger incisions needed in open surgical procedures. Laparoscopic surgery belongs to the broader field of endoscopy. The key element in laparoscopic surgery is the use of a laparoscope: a telescopic rod lens system, that is usually connected to a video camera. Also attached is a fiber optic cable system connected to a 'cold' light source (halogen or xenon), to illuminate the operative field, inserted through a 5 mm or 10 mm Trocar to view the operative field. The abdomen is usually insufflated with carbon dioxide gas to create a working and viewing space. The abdomen is essentially blown up like a balloon (insufflated), elevating the abdominal wall above the internal organs like a dome. The gas used is CO2, which is common to the human body and can be absorbed by tissue and removed by the respiratory system.