Single Incision Laparoscopic Surgery (SILS)

By

Dr. Ashish Shah

Consultant General/Gastroenterology/Laparoscopic

Surgery, Wockhardt Hospitals

Anatomy of the Digestive System

Gall Bladder Diseases

Symptoms of Gall Stones

• Abdominal pain – after food

• Back Pain

• Chest pain

• Nausea/Vomiting

• Jaundice

Symptoms of appendicitis

• Abdominal pain – periumbilical/right lower abdominal pain

• Nausea/Vomiting

• Fever

Laparoscopic Surgery

Conventional Laparoscopic Cholecystectomy/Appendicectomy

4 Ports (keyhole) for Cholecystectomy & 3 for Appendicectomy

SILS- A Perspective

• Global:

• Gained popularity in the last 1-2 yrs

• Currently offered at major laparoscopy centres

• India:

• Introduced about 1yr ago in Mumbai

• Very few centres offering SILS due to lack of expertise and equipment

SILS – Single Incision Laparoscopic Surgery

Laparoscopic surgery through one 20mm incision (cut) at the umbilicus

SILS – The Procedure

SILS –The Wockhardt Experience

• 4 months (4/05/09 till date)

• 10 patients – 9 Female pts, 1 Male pt

• 7 Cholecystectomies – 6 Female, 1 Male

• 4 Appendicectomies – 4 Female

• Youngest – 21 yrs (Appendicectomy)

• Oldest – 62 yrs (Cholecystectomy)

SILS – Wockhardt Experience

• Recovery: In hospital-Ambulation 3 hrs post operation

• Stay: Overnight stay

• Analgesia (Pain medication): Decreased requirement-compared to conventional Laparoscopic

• Earlier return to routine activity

SILS v/s Conventional Laparoscopy

• Cosmetically superior

• Lesser pain and decreased need for analgesics

• Earlier recovery

• Earlier return to activity

• Applicable to many common surgical conditions – GB stones, Appendicitis, Hernia, to name a few

Who can perform SILS?

• Experienced Laparoscopic Surgeons who routinely perform advanced Laparoscopic surgeries

• For whom:

All patients who would need Laparoscopic surgery especially for uncomplicated Gallstones, Appendicitis or Hernia

Way forward…

• SILS-The next big step forward in Laparoscopic Surgery

• Offers cosmetic benefit and quicker recovery than conventional Laparoscopy

• Applicable to patients requiring Laparoscopic procedures for uncomplicated conditions

• SILS offered routinely to suitable patients at Wockhardt Hospital, Cunningham Road

Thank You