Single Incision Laparoscopic Surgery (SILS)

One Tiny Incision Can Change Your Life

 

“I had a SILS gallbladder removal, went home the same day and was able to throw my daughter’s birthday party the following day.” 
Navy Wife Rebecca Kammerer

 

Who knew surgery could be like this? Northridge Hospital is taking laparoscopic surgery one step further. With a bigger vision and the latest technology, our physicians now perform gallbladder and weight loss surgeries through a single incision with the Minimally Invasive Single Incision Laparoscopic Surgery (SILS) procedure.

In contrast to the multiple entry points required by traditional laparoscopy, this single 20 mm incision (the size of a nickel) through the belly button further enhances the benefits of laparoscopic surgery by reducing the scars and wound pain that may accompany additional sites of entry.

During the procedure, the surgeon inserts into the belly button incision a SILS Port, a soft and flexible instrument equipped with three distinct openings. It allows for the use of three surgical devices at the same time.

This ability to articulate instruments enables the surgeon to approach the surgical site from different angles, thereby improving visualization. Because the incision is obscured, the potential for visible scarring may be reduced – a clear advantage over traditional laparoscopic surgeries that can leave visible scars at sites of entry. Patients also experience reduced pain and a faster recovery.

SILS Gallbladder Removal 
The gallbladder is a small organ that assists in digestion, but is non-vital. Cholecystectomy or gallbladder removal is typically needed to remove gallstones or an infected or inflamed gallbladder.

A SILS Cholecystectomy (removing the gallbladder) is performed through one small incision in the belly button as opposed to the three to four incisions required by standard laparoscopic surgeries. The procedure can relieve pain, treat infection and, in most cases, stop gallstones from returning.

SILS Weight Loss Surgery
A SILS Sleeve Gastrectomy is a minimally invasive weight loss procedure offered at our Center for Weight Loss Surgery. It is an intermediary procedure when considering the Lap-Band and Gastric Bypass. Patients prefer Sleeve Gastrectomy as there is no need for a foreign body such as the band, and therefore no frequent adjustments needed.

Through one nickel-size incision, surgeons perform a SILS Sleeve Gastrectomy to create a small, sleeve-shaped stomach about the size of a banana. Physicians and patients value the procedure because the weight loss is more predictable, it has shown good long-term success, does not carry the risk of malnutrition and long-term complications are virtually zero. It also has good outcomes with regards to resolution of diabetes, hypertension, sleep apnea and osteoarthritis.

Frequently Asked Questions

What exactly is the SILS™ procedure and how does it work?
The SILS™ cholecystectomy was first described in 1997 with favorable outcomes. SILS is a laparoscopic surgical procedure using a single incision (through the belly button) to perform a gallbladder removal. By utilizing just one 20 mm incision, the SILS™ procedure avoids the multiple entry points – usually involving up to four ½-inch or smaller incisions – required by traditional laparoscopic techniques.

Who is a candidate for the SILS™ procedure?
Generally, candidates for laparoscopic surgery are also candidates for the SILS™ procedure. Criteria may include: no prior surgery and an elective or non-emergent case.

How are SILS™ procedures different from other laparoscopic surgical procedures?
Instead of requiring the four ½-inch or smaller incisions associated with traditional laparoscopic surgery that may leave visible scars, the SILS™ procedure is accomplished with a single 20 mm incision through the belly button resulting in the potential for no visible scar. Moreover, a single incision minimizes the pain that may be associated with the additional sites of entry.

What instruments are utilized to perform SILS™ procedures?
Specialized instrumentation provides surgeons with the necessary tools to conduct SILS™ procedures.

SILS™ Port: The SILS™ Port is the first device specifically indicated for multiple instrument access through a single incision. The SILS™ Port facilitates the insertion of 3 hollow tubes or cannulae through which instruments are passed.

The SILS™ Port features a valve that allows surgeons to inflate the abdomen for optimal instrument access. It provides stability/support for hand instruments, maximum movement of instruments, and can be easily removed.

SILS™ Roticulator™ Instruments: The Roticulator™ instrumentation consists of two distinct components that work together to provide surgeons with maximum versatility and range-of-motion. The first component is a 5mm shaft that is designed for 360-degree rotation.

The second component is the instrument tip, which is capable of 80-degrees of movement left to right and top to bottom. These unique features enable the Roticulator™ instruments to facilitate hand-like access to difficult anatomy and provide improved ease of use.