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Single Incision Laparoscopic Surgery (SILS)
General Surgery / Jun 12th, 2016 6:53 am     A+ | a-

It was considered a major breakthrough in the field of bariatric surgery and could soon become one of the best decisions for nominally invasive operation for patients who are obese. Single Incision laparoscopic Surgery is an innovative procedure whereby the doctor uses a single incision to insert the camera and the tools to carry out bariatric surgery procedure. Single-Port Laparoscopic (SPL) is also known as Single Port Access Surgery (SPA), the Single-Port Incisionless Convensional Equipment-utilizing Surgery (SPICES), Single-Incision Laparoscopic Surgery (SILS) Single-Access Endoscopic Surgery (SAES) Laparo-Endoscopic Single-site Surgery (LESS), One-Port Umbilical Surgery (OPUS) and Natural-Orifice Transumbilical Surgery (NOTUS), is a recently developed laparoscopic technique. It is a minor invasive surgical process in which the surgeon operates nearly all through a single entry point, typically the patient's umbilicus. Unlike an old multiport laparoscopic approach, Single-Port Laparoscopy leaves little scar. Here's a look at how the process work and what its main advantages.
How it works?
Technical SILS was used to perform many types of surgery, including adjustable gastric band, appendectomy, colectomy, cholecystectomy, hernia treatment, hysterectomy, sleeve gastrectomy, and Sacrocolpopexy nephrectomy. SILS was used by surgeons at the Cleveland Clinic for clinical trials and the Geneva University Hospital in Switzerland. Despite a series of single-incision use of specialized technical instruments, many SILS surgeries in the United States of America and Europe have used the standard instrumentation. TriPort+ can be inserted with its device through an incision 15 mm in the navel. This device allows you to use four instruments simultaneously. LESS cholecystectomy period a fourth instrument becomes essential for the critical vision. Until now, surgeons had the invention as to retract the infundibulum; Sutures were reported and other means retraction novel. The instrument channel allows a fixed curved grasper Infundibular is added; which contributes to reproduce the methodology currently practiced in the traditional four-port laparoscopic cholecystectomy.
Laparoscopic single incision surgery may be performed by making a small incision in or near the navel and the insertion of laparoscopic instruments required directly into the body. For gastric banding procedures, the implementation of adjustment port requires to make a small flap subcutaneously. For gastric bypass procedures, perhaps the doctor will make a small vertical incision around the navel only.
Once the incision is made, the physician uses the Veress technique, where the instrument panel is raised and the needle is inserted directly into the incision. Many surgeons may decide to use a port that makes it easy to view all the layers of fabric. A flexible tube which can be moved at least 180 degrees can also be used with this method. The instrument provides the surgeon with a wider field of view and work at every stage of the operation quickly and efficiently.
Technology, Equipment and Training
SPL is achieved through a single 20 mm incision in the umbilicus (navel or belly button), or only 11 mm incision in the navel, which minimizes scarring and incisional pain associated with multiple entry points   used for traditional laparoscopic surgery. Specialized equipment to the SPL surgery is divided into two major categories; Access and hand tools ports. There are a number of different ports, including Applied Medical GelPOINT system, the SILS device Covidien, the TriPort +, and TriPort15 QuadPort More Advanced Surgical Concepts and Uni-X P navel. Hand instruments are available in three standard configurations - rigid joints and pre-folded. Standard hand tools are rigid in design and have developed over the past 30 years for use in laparoscopy. The seal is designed to overcome one of the challenges inherent in the SPL, reduced triangulation of tools. Many factors influence the decision of a surgeon to use standard or articulated hand tools, including access to the port by using own surgical skills and express the cost of the instruments are much more expensive than standard instruments.

SPL is enhanced by the use of specialized equipment, such as the SILS Port Multiple Instrument Access manufactured by Covidien and the angle of common instruments Laparo made by Cambridge Endoscopic Devices, Inc. The flexible port medical devices that can be installed through a small incision in the navel to allow laparoscopic surgeons use up to three devices simultaneously. Some instruments of articulation can be inserted through said specialized ports, offering surgeons maneuverability and access to the target tissue of a single access laparoscopic appendectomy point. However single port also made using a single 10 mm standard "Y" shaped operating telescope which an instrument channel 5mm also.
Although knowledge of the single port surgery is high among surgeons, using specialized instruments with this limited access, it requires skill and considerable training. This training and operational knowledge is currently limited and numerous bad insights of increased operating time and complications with this surgery are maintained. A recent study suggests future absorption depends largely on the availability of testing, training, implementation and cost reduction.
Key benefits of surgery
According to Dr. Ovunc Bardakcioglu, a gastrointestinal surgeon at SLU Hospital which several gastrointestinal procedures through single incision laparoscopic technical, The procedure of simple incision is revolutionary in the surgical field as gastro researchers and physicians, we are always looking for the most effective and least invasive techniques for the benefit of our patients. Incision laparoscopic surgery one may soon become the preferred method for the future method. The first lap band surgery a single incision was completed in summer 2008 by surgeons at UT Southwestern Medical Center in Texas.

This procedure offers several advantages including:
- Faster healing time
- Fewer Injuries
- Reduction of future scars
- The scars remain hidden
- Short hospital stay
Laparoscopic surgery is performed only by a few dozen of surgeons in the United States. It continues to be an attractive alternative for patients who do not submit to the ancient stomach bypass or stomach banding procedure.
What to expect after surgery
Patients who undergo laparoscopic technique gastric bypass surgery with a single incision typically spend between one and three days in the hospital for recovery. The Cleveland Clinic advises patients taking between two and four weeks off to fully recover from the procedure, and the patient should follow a healthy diet to accommodate the size of the stomach smaller.
Dr. Seema Yadav
Apr 27th, 2020 4:41 am
Thank you so much for this inspirational video. Thanks for posting of Single Incision Laparoscopic Surgery (SILS) video.
Dr. Dipankar Das
May 18th, 2020 11:57 am
Your lecture is very informative and well presented. It was very interesting,Thanks for posting of Single Incision Laparoscopic Surgery (SILS) video.
Dr. Vinay Rajpoot
May 23rd, 2020 5:40 am
It was as a really very interesting video presentation of Single Incision Laparoscopic Surgery (SILS).Thanks for the refresher!
Dr. Raman Bhalla
Jun 12th, 2020 8:24 am
Great surgery and great demonstration by great surgeon, Thanks Dr. Mishra for sharing this video of Single Incision Laparoscopic Surgery (SILS).
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