A minimally invasive procedure literally means any procedure less invasive than traditional open surgery used for the same purpose. Minimal Invasive Surgeries, provide the benefits of fewer scars, less pain, and shorter recovery periods, Single Incision Laparoscopic Surgery (SILS) or Scar Less Surgery is one of the newest laparoscopic techniques.
SILS is a cosmetic delight to the younger age scar conscious population. Single Incision means only one Incision at belly button instead of three to four smaller half-inch incisions of standard minimal access laparoscopic surgery.
A laparoscope (special telescope designed for medical use) is connected to a high intensity light source as well as a high-resolution camera which in turn is connected to monitor. This allows the surgeon to view the abdominal cavity.
SILS involves the use of cutting edge technology, (including specially-designed port which accommodates a camera and two laparoscopic instruments which are manipulated by the surgeon to operate,and flexible instruments) and a higher level of expertise.
Comparison with traditional Laparoscopic surgery:
In traditional laparoscopic surgery, ports are inserted through three to four small cuts, each measuring around ½ – 1 cm. A telescope attached to a camera inserted through one of the ports allows the surgical team to observe a magnified picture of the internal organs on a television screen. The surgeon carries out the surgery with the help of instruments introduced through the ports.
In SILS, the surgeon makes only one incision of around 1.5 cm – 2 cm (commonly just below the navel) to allow placement of three thin ports side by side. Else, a specially designed port 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.
Post Surgery Care:
Most people go home within 1-2 days (depending on the procedure performed). Some soreness around the incisions is normal for 3-4 days. Pain will get better every day. Person can take shower (no baths/pools/soaking in water for 10-14 days). You will be able to go up and down stairs and you will be able to drive when you feel up to it.
Single-Incision Laparoscopic Cholecystectomy (SILC) has rapidly spread throughout the world because of its low invasiveness and because it is a scar less procedure.
Currently, the following operations can be performed by SILS
- Removal of gallbladder (cholecystectomy)
- Removal of appendix (appendicectomy)
- Repair of paraumbilical or incisional hernia
- Diagnostic laparoscopy with biopsy
- Sleeve Gastrectomy (obesity surgery)
SILS may not be applicable to some patients, e.g.
- Very obese patient
- Patient with multiple previous abdominal operations
- Patients who are likely to have grossly enlarged or thickened diseased organ e.g. an acutely inflamed gallbladder
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.
One of the advantages of laparoscopic surgery is tiny scars which fade away with time. Single Port Access surgery is being done increasingly where surgeon operates laparoscopically almost exclusively through a single cut at navel (belly button) rather than multiple cuts. Only a tiny bandage is required to close the opening. Since the entire surgery is performed through the navel, it does not leave any visible scar giving better cosmetic results.