Evaluation of the Use of Single Incision Laparoscopic Surgery (SILS) in Bariatric Surgery

Fawaz C.torab, MD, PhD, Mohd Yasser Alkayyal, MD, FRCSI, FACS, Haytham Elsalhat, MD, Franck Branicki, MD, FRCS, FACS

Tawam Hospital/FMHS UAE university

Introduction: Single-incision laparoscopic surgery (SILS) has the potential advantages of reduced postoperative pain and reduced port-site complications. In this article, we present our first experiences with SILS gastric banding (LGB) and laparoscopic sleeve gastrectomy (LSG) in the UAE in comparison to the international results.

Methods: Since May 2009, 73 carefully selected patients (Average body mass index 41.2, between 38.5 and 47.5kg/m(2) with peripheral obesity) underwent LGB in 18 patients and LSG in 55 patients using this single incision technique. The same surgeon performed all surgical interventions. For all patients, the same perioperative protocol and operative techniques were implemented.

Results: Three LGB and one LSG were converted to standard laparoscopy. Three LSG needed additional 5 mm port. Mean operative time was 110 (95-165) minutes for LGB and 180 (70-350) minutes for LSG. The mean postoperative pain score was 06/10. 2 patients were totaly pain free, 6 hours after LGB. There were no postoperative complications after LGB. After LSG, there were two wound healing problems, two intraabominal bleedings and three leaks from the stapler line at the level of oesophageo-gastric junction. All patients were very pleased with the cosmetic outcome.

Conclusion: Single incision laparoscopic surgery is feasible, allowing for scarless abdominal operations. This early experience suggests that outcomes are comparable to standard laparoscopic surgery but with improved cosmesis, however, long term results are awaited to confirm these findings. A new learning curve to reduce the timing of operation and the rate of postoperative complications is needed even for those surgeons who are performing advanced minimal access surgical procedures.

Session: Poster Presentation

Program Number: P518

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