Manish Khaitan

Single port Bariatric Surgeries

Traditional laparoscopic surgeries use a telescopic rod attached to a video camera called a laparoscope, which is inserted through a small incision. Apart from this, 3 to 5 additional small cuts are made to insert the other surgical instruments to perform the surgery.

However, single-incision laparoscopy surgery (SILS) is a revolutionary minimally invasive surgical procedure conducted through a single incision. It provides a better cosmetic outcome, as a small incision is made through the patient’s navel or belly button, resulting in an almost scar less outcome.

Indications

Most patients who are good candidates for laparoscopic surgery are eligible for single-port procedures. Some of the surgeries that single incision laparoscopy is indicated for include cholecystectomy (removal of gall bladder), appendectomy (removal of appendix), splenectomy (removal of spleen), hepatectomy (removal of liver) and adrenalectomy (removal of adrenal glands). SILS can also be used for diagnostic purposes.

However, patients who have previously undergone multiple major surgeries to the abdominal region and those who are morbidly obese are not considered for SILS.

Procedure

Single Incision Laparoscopy is usually performed as day surgery either in the hospital or outpatient surgery centre under general, regional, or occasionally local anaesthesia depending on the type of procedure performed and the surgeon’s preference.

The patient is made to lie down in a tilted position so that the feet are placed higher than the head. The surgeon makes a single incision of about 3/4th of an inch at the belly button and injects a harmless gas to expand the area and obtain a clear view of the operative site. A tube called a trocar or port is placed through the incision, through which the laparoscope (a narrow telescope having a light source and camera) and tiny surgical instruments are inserted. The laparoscope guides your surgeon with images of the abdominal contents that can be viewed on a large screen. Once the diseased organ is excised, your surgeon removes the instruments, releases the gas, and closes the incision with a small bandage.

Recovery

Common post-operative guidelines following Single Incision laparoscopy include the following:

  • You will need someone to drive you home after you are released as the anaesthesia may make you feel groggy and tired.
  • Do not remove the dressing over the incision for the first two days and keep the area clean and dry. No showering or bathing during this time.  The incision usually heals in about 5 days.
  • Your surgeon may give you activity restrictions such as no heavy lifting. It is very important that you follow your surgeon’s instructions for a successful recovery.
  • You may feel soreness around the incision area. Your surgeon may give you a prescription pain medicine or recommend NSAID’s (non-steroidal anti-inflammatory drugs) for the first few days to keep you comfortable.
  • If the abdomen was distended with gas, you may experience discomfort in the abdomen, chest, or shoulder area for a couple days while the excess gas is being absorbed.

Contact your doctor immediately if you have a fever, chills, increased pain, bleeding or fluid leakage from the incisions, chest pain, shortness of breath, leg pain, and or dizziness.

Risks and complications

As with all surgical procedures, SILS can be associated with certain risks and complications such as infections, blood loss, nerve damage and allergic reactions to medications, although these are rare. Contact your doctor immediately if you have a fever, chills, increased pain, bleeding or fluid leakage from the incision, chest pain, shortness of breath, leg pain, and or dizziness.

Benefits

Several benefits account for the increasing popularity of SILS when compared to conventional laparoscopy. These include:

  • Speedy recovery
  • Reduction in post-operative infections and pain
  • Reduction in the duration of hospital stay
  • Smaller or no visible scar

 

 

 

 


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