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SILS - Single Incision Laparoscopic Surgery |
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A new surgical technique known as SILS – single incision laparoscopic surgery – is now available for some bariatric operations, including the Adjustable Gastric Band (AGB) and the Laparoscopic Sleeve Gastrectomy (LSG). It involves performing the entire procedure through a single small incision, ideally at the umbilicus (belly button). SILS is usually less painful than standard laparoscopic surgeries (4-6 small incisions), and the cosmetic effect is thought to be superior.
SILS surgeries are 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 operations. For the AGB 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 procedure 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 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 is favorable. This depends on the individual patient and their surgeon’s judgment. If you are interested in the SILS version of either the AGB or the LSG operations, please ask your surgeon prior to starting the process to qualify for weight loss surgery.
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