Single incision sleeve gastric vs standard sleeve gastric.

Question

How bad is the scar after sleeve gastric. Can i still wear the swimsuit in the future? I looked into the one incision sleeve gastric, but it says the single scar could be much bigger than the 5 small one, and it could have more complications than standard sleeve gastric. Is this true? Thanks.

Shawn Garber, MD, FACS, FASMBS · Answer

I disagree with both surgeons.  Most bariatric surgeons will speak negatively about SILS sleeve gastrectomy because it is a technically challenging procedure if you do not know how to perform this technique.  Most surgeons in the USA do not have the technical skills or equipment necessary to perform the procedure with this technique and will therefore talk negatively about a technique they do not know how to perform. That being said, I have performed thousands of sleeve gastrectomy using the SILS technique which uses one tiny scar (not larger) as previously mentioned that is completely hidden in the base of the belly button. I have previously published a paper on decreased pain and improved cosmetic results with SILS versus standard technique. The SILS technique can not be used on all patients, but I use it in about 80% of the sleeve gastrectomies I perform and the surgery usually only takes about 25 minutes with absolutely no struggle. Obviously you should only choose a bariatric surgeon hat is very experienced with this technique.

Wiljon W. Beltre, MD · Answer

Yes, the single incision tends to be bigger than the standard five small ones.  There is also an increased chance of incisional hernias with the single larger incision.  The five small laparoscopic incision for the sleeve look similar to the gall bladder incisions for laparoscopic cholecystectomy.  Depending how you heal, the incisions are hardly noticeable.  Depending on your anatomy, sometimes the bigger of the five incisions can be hidden in the belly button.

Guillermo Alvarez, MD · Answer

Yes you are right, the 5 incisions done in a regular sleeve are very small and hardly noticeable in most patients 8-10 months down the road. A single incision sleeve does require a bigger incision that will be noticeable and is related to more complications like the development of hernias on that precise site. warm regards, Dr. Alvarez

Mark Pleatman, MD (retired) · Answer

I agree with Dr. Beltre.  In addition, squeezing the camera and all the instruments through one incision makes the operation more difficult.  Why would you want your surgeon to struggle?

Single incision sleeve gastric vs standard sleeve gastric.

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