Single Incision Laparoscopic Surgery - Know More!

Hello,

My name is Dr. Nitin Jha and I am a senior laparoscopic surgeon. Today we will be talking about something called is SILS that is single incision laparoscopic surgery, as the name suggests, single incision laparoscopic surgery is a way of doing laparoscopic surgery by only one cut at the navel instead of the routine three or four cuts that normally we take for any laparoscopic surgery like for example for laparoscopic gallbladder surgery for gallbladder stones, previously we had to put around 3 or 4 small incisions, one in the navel, one in this area and one or two in this area. So this is the standard way of doing laparoscopic surgery and now we can do it by a very small cut inside the navel, very easily hidden and from outside you will not come to know from where the surgery has been done so this is what we call as a single incision. In the same way we do the surgery for a hernia. If you have incisional hernia anywhere in this area or umbilical hernia, we do it by a small cut here in the left lateral side or the side of the abdomen and that is almost like 1-1.5 cm long and that is only cut which is required for doing the laparoscopic hernia surgery also and similarly for appendix instead of the routine 3 cuts that is usually taken by all surgeons, normally we do it by single incision in which we just put a small cut again in the navel and that is sufficient to do the surgery, so this is what is called as single incision laparoscopic surgery.

The advantages compared to the single incision and the standard way of doing laparoscopic surgery is that in standard way you have around 3 to 4 cuts, so ultimately you have small wound scars but in single incision there is only one scar inside the navel so practically from outside you don't come to know about it that from where the surgery has been done. The 2nd advantages because the number of cuts are less, so the number of scar are less so the amount of pain is also supposed to be less in single incision surgery and obviously cosmetically it is better because the operative scar is almost like hidden, so don't come to know from where the surgery has been done. Another advantage is that the time of recovery is very less come in single incision as compared to the standard three-port, four-port surgery. Single-incision has its own drawbacks also in the form that we cannot in all patients we cannot provide this way or technique of doing surgery because suppose the gallbladder is very badly stuck or the appendix is very badly stuck then obviously we are not able to do it by single incision we have to convert it to normal four-port technique, so that is why before entering our scope inside it is very difficult to know whether in that typical case we will be able to do by the single incision or by the standard four-port, only once we put our scope inside, we have a look at the appendix or the gallbladder or the hernia and how good or bad of a condition it is that we will be able to do it by single incision or we will have to go with the conventional three or four-port technique.

This is one of the more reason why we should not allow any disease to become that bad, suppose you start having pain of appendix you should be done as soon as possible, suppose you start having pain of gallbladder surgery, gallbladder stones, you should do it as early as possible because the earlier we diagnose, the earlier we treat the disease, it is more simple, the more time that we waste in diagnosing or more time we will waste in deciding, becomes more and more complex and in that case we have to basically resort to the four-port technique or sometimes even open surgery if there are a lot of other complications of the disease. So that is why the sooner we tackle the disease, the easier it is to operate and the more chances of single incision surgery as compared to any other standard way of doing surgery.

Thank you