A London surgeon is pioneering a new way to remove abdominal organs through the belly button using an approach called single incision laparoscopic surgery (SILS) which requires only a 10 mm cut in the navel to allow entry of a camera and all the surgical instruments and through which organs like the appendix and gall bladder can be removed.
Imperial College Healthcare NHS Trust consultant surgeon Paraskevas Paraskeva, who also lectures at Imperial College London, is the first UK surgeon to use SILS to remove an appendix and a gall bladder.
Before SILS the organs were removed using three cuts in the torso, as well as the belly button, which leaves the patient with abdominal scars.
But SILS uses only one 10 mm “single access port” through which the surgical instruments and a camera are inserted, and through which the excised organ is removed and then the belly button is sewn up.
The procedure takes about 20 minutes for an appendix and an hour for a gall bladder, and the patient generally goes home on the same day. Paraskeva said in a statement last month that:
“This technique further minimises minimally invasive surgery.”
“Having a single access port minimises the discomfort to the patient, reduces the risk of infection and because the incision is through the belly button, the surgery is scarless,” he added.
SILS is the product of research carried out by Paraskeva and his team at the department of biosurgery and surgical technology at Imperial College London.
Aberdeen Royal Infirmary (ARI) in Scotland has also been using SILS to remove appendices and gall bladders. They started to use the procedure after learning about urologists at the Cleveland clinic in the USA using it to remove part of a kidney and also after hearing about Paraskeva’s work at Imperial College London.
ARI’s consultant surgeon Irfan Ahmed said that when he offered this method to his patients they were “excited by the idea and delighted with the cosmetic results after surgery”.
He said:
“Single-incision laparoscopic surgery still needs to be studied in an academic setting before it becomes widely available.”
Ahmed said he thinks SILS will replace traditional laparoscopic procedures performed by surgeons and gynaecologists in selected conditions.
“I see it happening routinely in the next two years,” he said.
Consultant general surgeon Geoffrey Glazer, who is based at Wellington Hospital in London, told the BBC that as well as helping with the healing process, SILS was a “technological step forward” which might appeal to people who don’t want scars on their abdomen.
He said other methods are also being developed to remove organs through existing orifices so that extra incisions don’t have to be made.
One such method for example uses the rectum as the “access port”, but this carries a higher risk of contamination.
Sources: BBC, Imperial College Healthcare, NHS Grampian.
Written by: Catharine Paddock, PhD