What are your thoughts on a SILS sleeve? Does it carry risks?

Question

Dr’s what are your thoughts on a single incision sleeve? Does it carry risks? Is the procedure done in first time surgeries or can also be done in a revision band to sleeve operation where the band has already been removed? Are all laparoscopic surgeries done using 5 ports or do some use 3-4?

Gabriela Rodriguez, MD, FACS · Answer

Due to the complexity of a revision a SILS will not be advise, because of the limited (narrow) vision that gives you this approach. For a revision surgery were you are going to have scar tissue from the previous intervention you will need to be able to have a wide vision of the surgical field and have a good position of the instruments to be able to work comfortably and have good access to the surgical area.the laparoscopic approach for the sleeve can be done with 4 or 5 incision, one of this can be hidden on your belly button and the rest of them are very small, they range from 5mm to 12mm the biggest one.

Ali Solmaz, MD · Answer

A single-incision sleeve gastrectomy, also known as SILS (Single Incision Laparoscopic Surgery), is an innovative approach to weight-loss surgery that offers potential advantages, but it also carries specific risks and considerations. This technique involves performing the entire procedure through a single incision, typically in the umbilical area, which can result in reduced scarring and potentially faster recovery compared to traditional multi-port laparoscopic surgery.
In terms of risks, single-incision surgery may pose technical challenges for the surgeon due to limited visualization and maneuverability, which can slightly increase the risk of complications, such as bleeding or leaks. However, in the hands of an experienced bariatric surgeon, these risks are typically well-managed. It’s essential to ensure that the surgeon performing the procedure is highly skilled in this specific technique.
The single-incision sleeve is primarily performed in first-time surgeries, as the anatomy is more predictable in these cases. For revision procedures, such as converting from a gastric band to a sleeve gastrectomy, the complexity of the surgery increases, especially if the band has already been removed and there is scar tissue or altered anatomy. While it may be technically possible to perform a revision as a single-incision procedure, most surgeons prefer traditional multi-port laparoscopic approaches for better access and safety in such cases.
Regarding the number of ports used in laparoscopic surgery, it varies depending on the surgeon’s preference and the complexity of the procedure. While five ports are standard in many cases, some surgeons successfully use three or four ports, depending on their experience and the patient’s anatomy. Single-incision surgery represents an even more advanced variation of this, requiring specialized skills and equipment.

H. Joseph Naim, MD, FACS · Answer

There is really no room in current atmosphere for Single Incision Laparoscopic Sleeve (SILS) or any other Bariatric Surgery.These types of procedures have been shown to be safe, with minimal down time with standard laparoscopic techniques. Limiting the exposure, or limiting the access using SILS, provides no additional benefit to patients or surgeons.

Edgar Serrano, MD - Account Suspended · Answer

Comparison of Single-Incision Gastric Sleeve (SILS) and Five-Port Gastric Sleeve (5PS)
Single-Incision Gastric Sleeve (SILS)
Advantages:
Smaller incision and less scarringReduced risk of infectionShorter hospital stayQuicker recovery timeImproved cosmetic outcomeDisadvantages:
More technically challenging for the surgeonMay not be suitable for all patientsLimited range of motion for the instrumentsIncreased risk of bleedingFive-Port Gastric Sleeve (5PS)
Advantages:
More established techniqueWider range of motion for the instrumentsLess technically challenging for the surgeonSuitable for most patientsDisadvantages:
Larger incisions and more scarringIncreased risk of infectionLonger hospital stayLonger recovery time
Overall, the single-incision gastric sleeve (SILS) offers several advantages over the five-port gastric sleeve (5PS), including smaller incisions, less scarring, and a shorter recovery time. However, the SILS is a more technically challenging procedure, and it may not be suitable for all patients. The 5PS is a more established technique, and it is suitable for most patients. However, the 5PS is associated with larger incisions, more scarring, and a longer recovery time.
Ultimately, the best type of gastric sleeve surgery for you will depend on your individual circumstances and preferences. It is important to discuss the risks and benefits of both procedures with your surgeon before making a decision.

Pablo Garcia, MD - Account Suspended · Answer

Hello, I hope you are well. There have been several studies comparing SILS and a regular sleeve, and no differential risks have been reported. Statistics are more or less the same. Generally speaking, deciding on the approach depends on the surgeons preference. However, I recommend you bring this up to your bariatric surgeon so you can receive all the educational information you may need.

What are your thoughts on a SILS sleeve? Does it carry risks?

Answers (5)

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