SILS -- Single Incision Laparoscopic Surgery

[MsJacquiiC]

A new weight loss surgery technique known as SILS ? single incision laparoscopic surgery ? is now available for some bariatric operations, including the Adjustable Gastric Band and the Laparoscopic Sleeve Gastrectomy. It involves performing the entire procedure through a single small incision, ideally at the umbilicus (belly button).

SILS requires specialized instruments that are able to articulate (bend into angles), and a novel camera that can be turned to a variety of angles.

SILS is usually less painful than standard laparoscopic surgeries (4-6 small incisions), and the cosmetic effect is thought to be superior. Some obesity surgery cases still need a balance of diet and exercise after the surgery to maintain long term results.

SILS weight loss surgery is done under general anesthesia with the patient completely asleep. A small incision is placed at the umbilicus and either 3 standard trochars (tubes through which the instruments are passed) or a single specialized SILS port is placed to gain access to the abdominal space. The space is then insufflated with carbon dioxide to create enough room to manipulate the instruments.

SILS requires specialized instruments that are able to articulate (bend into angles), and a novel camera that can be turned to a variety of angles. The operation is done using the same methods as the regular laparoscopic surgery. For the adjustable gastric band procedure a tunnel under the skin and fat layer is created to place the port for later band adjustment. This is required to move it away from the umbilicus.

Postoperatively, the patient will only have one incision, usually with less pain than a weight loss surgery with 4 to 6 incisions. Also, as the scar heals and contracts it usually becomes less noticeable as it is partially hidden by the umbilicus. Most weight loss patients feel this has a better cosmetic result.

Not all patients can have the SILS approach. It is best used in patients of lower weight (BMI of 35 to 45) and whose body habitus (the physical and constitutional characteristics of an individual) is favorable. This depends on the individual patient and their surgeon?s judgment. Body mass index (BMI) is a measure of body fat based on height and weight that applies to both adult men and women.

BMI-Body Mass Index formula is a specific calculation. For basic understanding of the BMI, here is a simple example. A person who is 5?5? to 6?0? with a weight of 225 to 300 pounds could be a possible SILS candidate. For each 7 to 8 pounds of body weight, they will get 1 point of BMI. So, if you divide 250 pounds by 7 you will have an estimated BMI of 36.

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Source

Body Mass Index BMI A statistical method of figuring out the degree of excess or insufficient weight based on one's height & weight. Though the controversial BMI does not actually measure the percentage of body fat, it is a useful tool to estimate a healthy body weight based on how tall a person is.

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.

Obesity Obesity results from the excessive accumulation of fat that exceeds the body's skeletal and physical standards. Obesity has been defined as a weight more than 20% above what is considered normal according to standard age, height, and weight tables, or by a complex formula known as the body mass index. According to the National Institutes of Health (NIH), an increase in 20 percent or more above your ideal body weight is the point at which excess weight becomes a health risk. CLICK HERE TO OPEN THE JOURNEY BMI CALCULATOR!

Gastric Banding Surgery The adjustable gastric banding is a restrictive surgical procedure during which a silicone band is placed around the stomach, creating a small pouch. The band includes a balloon that is filled with a nontoxic fluid, most commonly a saline solution; periodic adjustments are performed by a healthcare professional who accesses the balloon via a subcutaneous port. Gastric band placement, unlike malabsorptive weight loss surgery (e.g. Roux-en-Y gastric bypass surgery, Biliopancreatic Diversion, and Duodenal Switch), does not cut or remove any part of the digestive system. See WLS Videos for animated surgery technique.