SILS for Small Bowel Diseases

Laparoscopic surgery for treating diseases of the small bowel is performed through three cuts – a 1cm cut at the navel and two 5mm cuts in the lower abdomen. The surgeon passes tubes called “ports” through these small cuts. A telescope is introduced through one of them and two instruments through the other ports. It is possible to carefully examine whole of the small bowel loop by loop and identify the site of the problem. The incision near the navel is then extended to bring out the diseased segment of small bowel, excise it and join the ends back together. The small bowel is then placed back in the abdomen and the incisions are closed.

In a single incision laparoscopic surgery (SILS), the surgeon makes only one incision inside the navel and places all three cannulas or tubes through this. The entire small bowel is traced as described above and the diseased portion is brought out and excised in a similar manner.

Single incision laparoscopic surgery for small bowel disease

Invisible scar of single incision laparoscopic resection of small bowel

The surgeon would assess an individual patient to decide whether or not he / she are a suitable candidate for SILS. SILS may not be applicable to some patients, e.g.
Those who are very obese,
Those who have an acute intestinal obstruction and gross distention of small bowel reducing the working space inside the abdomen
Those who have had multiple previous abdominal operations and

Traditional laparoscopic surgery, of course, can be offered to all these groups of patients.

In 5% to 10% patients it may not be possible to complete the operation by SILS due to technical difficulties. The surgeon places one or two additional ports and completes the procedure in the traditional laparoscopic manner. Very rarely, it may be necessary to convert to an open operation. Both these issues are always discussed with patients prior to surgery and they are made aware that conversion to traditional laparoscopy or indeed to open surgery merely represents a sound judgment on part of the surgeon in the interest of patient safety.

Less pain from the single, short incision after surgery
Shorter hospital stay
Shorter recovery time
Faster return to normal diet
Faster return to work or normal activity
Better cosmetic healing (an almost invisible scar)

Download SILS for Small Bowel Diseases Brochure