In Single incision laparoscopic surgery, the surgeon makes only one incision of around 1.5 cm – 2 cm just below the umbilicus to allow placement of three thin 5mm port side by side parallel to each other. A specially designed SILS port is also available which is inserted into the abdomen; this port carries the telescope as well as the laparoscopic instruments. The surgeon then carries out an operation identical to a traditional laparoscopic one.
Operations which can be performed with SILS
Currently, the following operations can be performed by SILS
- Removal of gallbladder (cholecystectomy)
- Removal of appendix (appendicectomy)
- Repair of paraumbilical or incisional hernia
- Repair of Inguinal Hernia
- Sleeve Gastrectomy
- Removal of ovary (oophorectomy)
- Removal of Uterus (Hysterectomy)
- Diagnostic laparoscopy with biopsy
As the technique of single incision laparoscopic surgery gets refined and better instrumentation becomes available, the surgeons will be able to carry out many more operations today carried out by traditional laparoscopic surgery using the SILS approach. As there is only one incision the patient experiences much less pain as compared to traditional laparoscopic surgery and recovers faster. The healed incision leaves practically no scar, thus making SILS cosmetically a superior option. All patients enjoy these benefits, but SILS is of particularly great cosmetic value to ladies (as most would prefer to have as few scars as possible) and to busy corporate executives who wish to recover rapidly from surgery so as to get back to work. The surgeon or gynecologist would assess an individual patient to decide whether or not he / she are a suitable candidate for SILS. SILS may not be applicable to some patients, e.g. Those who are very obese, Those who have had multiple previous abdominal operations and patients who are likely to have grossly enlarged or thickened diseased organ. In 5% to 10% patients it may not be possible to complete the operation by SILS due to technical difficulties. The surgeon places one or two additional ports and completes the procedure in the traditional laparoscopic manner. Very rarely, it may be necessary to convert to an open operation. Both these issues are always discussed with patients prior to surgery and they are made aware that conversion to traditional laparoscopy or indeed to open surgery merely represents a sound judgment on part of the surgeon in the interest of patient safety. As SILS involves the use of specialized equipment, it is marginally more expensive as compared to traditional laparoscopic surgery.