Several Emory Crawford Long Hospital surgeons are now using a single entry point in the abdominal wall to remove gallbladders, appendixes and parts of the colon, rather than the standard four to six skin incisions used during standard laparoscopic surgery.
Some weight-loss and reflux surgeries can also be performed using this single laparoscopic incision. Reducing the number of incisions will decrease scarring and chances of infection, while also helping the patient to heal more quickly.
The procedure, known as single-incision laparoscopic surgery, or SILS, allows surgeons to make one single incision, about a half of an inch in length, through the umbilicus, or belly button. Through that entryway, the surgeons place an access port, which holds their special cameras and instruments during surgery.
“Single-incision laparoscopic surgery is an evolving technology which is showing great promise for patients who need minimally-invasive surgery,” says Charles R. (Rick) Finley, MD, chief of general surgery at Emory Crawford Long Hospital and private practice community physician. “Because there are fewer incisions, there is less chance of infection, less scarring and better cosmetic results, meaning patients can recover faster.”
Laparoscopic surgery has been around for years, but the need to refine the technology is growing, according to experts. That means there is also a need for improved surgical equipment.
“We’ve been working closely with some of the device companies in hopes of helping them develop better instrumentation for SILS,” says Edward Lin, DO, assistant professor of surgery, Emory University School of Medicine and director of the Emory Endosurgery Unit, which oversees minimally-invasive surgery and training at Emory. “As we move forward, we expect to see this technique being applied to more and more general laparoscopic surgeries, hence the need for more efficient devices.”
In some cases, the surgeons may need to make a second, small incision in the patient’s abdomen to complete the surgery. Excess weight, severe adhesions, significant infection or prior surgeries might increase the need for a second incision.
Laparoscopic surgery, has in many cases, replaced the need for traditional open surgeries in the abdominal or pelvic cavities. The abdomen is usually insufflated, or distended like a balloon, with carbon dioxide to create a working and viewing space. The carbon dioxide is then removed at the end of the procedure. Because there is no large, open incision, patients can often go home the same day of their procedure or have only a short hospital stay.
In addition, some Emory University Hospital surgeons perform SILS.