SILS FortCovidien SILS Ft Myers, FL

Laparoscopic Surgery and the Covidien SILS™ Procedure Q&A

What exactly is the SILS™ procedure and how does it work?

The SILS™ procedure is a laparoscopic surgical procedure using a single incision (through the belly button) to accomplish any number of treatments including gallbladder removal, gynecologic procedures (like hysterectomies) and others. By utilizing just one 20mm incision, the SILS™ procedure avoids the multiple entry points – usually involving up to four ½-inch or smaller incisions – required by traditional laparoscopic techniques.

 

Who is a candidate for the SILS™ procedure?

Generally, candidates for laparoscopic surgery are also candidates for the SILS™ procedure. Criteria may include: no prior surgery and an elective or non-emergent case.

 

How are SILS™ procedures different from other laparoscopic surgical procedures?

Instead of requiring the four ½-inch or smaller incisions associated with traditional laparoscopic surgery that may leave visible scars, the SILS™ procedure is accomplished with a single 20mm incision through the belly button resulting in the potential for no visible scar.  
 
Moreover, a single incision minimizes the pain that may be associated with the additional sites of entry.

Postop SILS Cholecystectomy Patient (Gallbladder Removal)

Post Op picture of gallbladder removal using SILS Procedure Post Op picture of gallbladder removal using SILS Procedure

SILS Postop

SILS after picture SILS close up

Male with SILS chole

SILS chole SILS chole

SILS chole after lap gastric bypass done 2 years prior

SILS chole after lap gastric bypass done 2 years prior SILS chole after lap gastric bypass done 2 years prior

 

What studies or clinical trials have been conducted to assess the safety of the SILS™ procedure?

Covidien is sponsoring the first prospective randomized controlled trial comparing traditional laparoscopic cholecystectomy vs. SILS™ cholecystectomy.  The purpose of this trial is to evaluate the benefits of SILS™ Port cholecystectomy vs. conventional 4-port laparoscopic cholecystectomy.
 
SILS™ cholecystectomy was first described in 1997.[i] <#_edn1>   Since that time the SILS™ procedure has been used to perform numerous additional procedures (e.g., appendectomy, hysterectomy, nephrectomy, etc.).

 

How do surgeons learn how to perform these procedures?

The Covidien SILS™ training program offers extensive education on this advanced minimally invasive surgical procedure, providing surgeons with the tools and knowledge necessary to carry out this new technique.

The training program consists of 4 modules that include both lectures and hands-on product training to ensure surgeons are comfortable with both the equipment and the techniques.  For qualified surgeons, the SILS™ training can be completed within a single day.  Surgeons may need to conduct several procedures to master the technique.
 
The SILS™ procedure is an advanced laparoscopic technique for which specialty training is strongly recommended.  Contact your local Covidien Surgical Device Specialist for training opportunities.

 

What instruments are utilized to perform SILS™ procedures?

Specialized instrumentation manufactured by Covidien provides surgeons with the necessary tools to conduct SILS™ procedures.

SILS™ Port

SILS Port

The SILS™ Port is the first device specifically indicated for multiple instrument access through a single incision.  The SILS™ Port facilitates the insertion of 3 hollow tubes or cannulae through which instruments are passed.  The SILS™ Port features a valve that allows surgeons to inflate the abdomen for optimal instrument access.  It provides stability/support for hand instruments, maximum movement of instruments, and can be easily removed.

SILS™ Roticulator™ Instruments

SILS Roticulator

The Roticulator™ instrumentation consists of 2 distinct components that work together to provide surgeons with maximum versatility and range of motion. The first component is a 5mm shaft that is designed for 360-degree rotation.  The second component is the instrument tip, which is capable of 80-degrees of movement left to right and top to bottom.

These unique features enable the Roticulator™ instruments to facilitate hand-like access to difficult anatomy and provide improved ease of use.

 

Are there risks associated with the SILS™ procedures?

Yes, any surgical procedure can result in complications.  According to the Agency for Healthcare Research and Quality, potential problems of any surgery could include pain, injury to organs, bleeding, infection, hernia, adhesions and scarring.[ii] <#_edn2>   Evidence currently supports that traditional laparoscopic procedures generally result in better quality-of-life outcomes than open surgery, but the SILS™ procedure itself has yet to undergo this evaluation.[iii] <#_edn3>

 

Where can one obtain more information on SILS™ procedures?

Visit www.sils.com.

 

Please comment on gallbladder conditions and treatment.

The gallbladder is a small organ that assists in digestion, but is non-vital. Cholecystectomy or gallbladder removal is typically needed to remove gallstones or an infected or inflamed gallbladder.  Removal in these cases will relieve pain, treat infection and, in most cases, stop gallstones from returning.[iv] <#_edn4>   

 

[i] <#_ednref> Navarra, G. et al. Short Note: One Wound Laparoscopic Cholecystectomy. Br J Surg, 1997.

[ii] <#_ednref> Agency for Healthcare Research and Quality. Surgery. NIH: Medline Plus, 2009.   Accessed March 17, 2009.
http://www.nlm.nih.gov/medlineplus/surgery.html   

[iii] <#_ednref> Velanovich, V. Laparoscopic vs. Open Surgery. Surgical Endoscopy, January 2000.  

[iv] <#_ednref> American College of Surgeons Division of Education. Cholecystectomy: Surgical Removal of the Gallbladder. Revised October 6, 2008. Accessed December 30, 2008. 
http://www.facs.org/public_info/operation/cholesys.pdf

 

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