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procedures
Single Incision Gastric Sleeve (SILS)
Bariatric procedure performed through a single incision, resulting in less invasive surgery and potentially faster recovery.
Quick Facts
| Weight loss | 60-70% of excess body weight is lost within 12 to 18 months. |
| Surgery time | Approximately one hour. |
| Hospital stay: | 2 days |
| Recovery time: | 2-4 weeks. |
Find answers to your questions
Consult our Frequently Asked Questions to obtain detailed information and clarify your doubts. We are here to help you make informed decisions.
Introduction
Obesity is a global health concern that affects millions of people worldwide and has become a public health problem in many countries (WHO, 2021). Among the multiple treatment options for obesity, bariatric surgery has established itself as an effective and safe intervention, offering sustained weight reduction and improvement in associated comorbidities (Angrisani et al., 2020). The Single Incision Sleeve Gastric Sleeve (SILS) is a minimally invasive surgical technique that has gained popularity in recent years due to its aesthetic advantages and potential benefits in patient recovery (Abu Gazala & Schlager, 2021). This article provides a clinical review, including its description, indications, results and possible complications.
Single Incision Sleeve Gastric Sleeve (SILS) Procedure
The Single Incision Sleeve Gastric Sleeve (SILS) technique is a variant of conventional laparoscopic sleeve gastrectomy, in which a single incision is made at the umbilicus instead of several incisions in the abdomen (Phillips et al., 2018). The operation is performed with the aid of special instruments, such as the flexible laparoscope and specifically designed trocars, allowing the surgery to be performed through a single entrance (Rosenthal et al., 2013).
Indications and contraindications
The indications for SILS are similar to those for conventional laparoscopic sleeve gastrectomy. They are indicated for morbidly obese patients with a body mass index (BMI) greater than or equal to 35 kg/m², or greater than or equal to 30 kg/m² with obesity-related comorbidities such as type 2 diabetes, hypertension, sleep apnea, among others (American Society for Metabolic and Bariatric Surgery [ASMBS], 2020). Relative contraindications include history of previous abdominal surgeries, umbilical hernias and patients with high anesthetic risk (Rosenthal et al., 2013).
Results and complications
Numerous studies have shown SILS to be a safe and effective procedure in terms of weight loss and resolution of comorbidities, with outcomes similar to those of conventional laparoscopic sleeve gastrectomy (Phillips et al., 2018; Saber et al., 2017). However, a lower rate of minor complications and faster recovery has been observed in patients undergoing SILS (Saber et al., 2017).
Potential complications include bleeding, staple line leakage, stenosis, and venous thromboembolism (Rosenthal et al., 2013). Despite these potential complications, the rate of serious adverse events is low in single incision gastric sleeve surgery (Abu Gazala & Schlager, 2021).
Advantages and disadvantages
The main advantage of the SILS technique is its minimally invasive and aesthetic approach, as the incision at the umbilicus is less visible and usually leaves minimal scarring compared to the multiple incisions of conventional laparoscopic sleeve gastrectomy (Phillips et al., 2018). In addition, less need for analgesics and faster recovery have been reported in patients undergoing SILS, which may decrease hospitalization time and improve postoperative quality of life (Saber et al., 2017).
However, the SILS technique has certain disadvantages, such as a longer learning curve and the need for specialized instruments (Rosenthal et al., 2013). In addition, some studies suggest that the duration of surgery may be longer compared to conventional laparoscopic sleeve gastrectomy, although this may improve as surgeons gain more experience with the procedure (Phillips et al., 2018).
Conclusions
Single Incision Sleeve Gastrectomy (SILS) is a minimally invasive and aesthetically appealing surgical technique for the treatment of morbid obesity. Clinical and academic studies demonstrate that SILS is safe and effective in terms of weight loss and resolution of comorbidities, with outcomes comparable to those of conventional laparoscopic sleeve gastrectomy.
Despite its longer learning curve and the need for specialized instruments, SILS offers advantages in terms of patient recovery and aesthetic results, making it a promising option in the field of bariatric surgery.
References
Abu Gazala, S., & Schlager, A. (2021). Single incision laparoscopic sleeve gastrectomy. In M. Gagner, M. Ramos-Levi, & A. Khorgami (Eds.), Sleeve gastrectomy: Surgical techniques, clinical aspects and complications (pp. 93-103). Springer. https://doi.org/10.1007/978-3-030-64484-0_7
American Society for Metabolic and Bariatric Surgery (ASMBS) (2020). Bariatric surgery procedures. Retrieved from https://asmbs.org/patients/bariatric-surgery-procedures
Angrisani, L., Santonicola, A., Iovino, P., Vitiello, A., Higa, K., Himpens, J., ... Buchwald, H. (2020). Bariatric surgery and endoluminal procedures: IFSO Worldwide Survey 2018. Obesity Surgery, 30(12), 4816-4823. https://doi.org/10.1007/s11695-020-04978-1.
Phillips, M. S., Marks, J. M., Roberts, K., Tacchino, R., Onders, R., & DeNoto, G. (2018). Intermediate results of laparoscopic sleeve gastrectomy and single-incision laparoscopic sleeve gastrectomy in 376 patients. Surgical Endoscopy, 32(2), 904-910. https://doi.org/10.1007/s00464-017-5815-1.
Rosenthal, R. J., Diaz, A. A., Arvidsson, D., Baker, R. S., Basso, N., Bellanger, D., ... Weiner, R. (2013). International Sleeve Gastrectomy Expert Panel Consensus Statement: best practice guidelines based on experience of>12,000 cases. Surgery for Obesity and Related Diseases, 8(1), 8-19. https://doi.org/10.1016/j.soard.2011.10.019.
Saber, A. A., El-Ghazaly, T. H., Dewoolkar, A. V., & Slayden, G. (2017). Early experience with single incision transumbilical laparoscopic adjustable laparoscopic gastric banding using the SILS Port. International Journal of Surgery, 39, 87-92. https://doi.org/10.1016/j.ijsu.2017.01.110.
World Health Organization (WHO) (2021). Obesity and overweight. Retrieved from https://www.who.int/news-room/fact-sheets/detail/obesity-and-overweight
CONSULT
You may be a candidate for weight loss surgery.
You may be a candidate for weight loss surgery if you meet any of the following criteria:
Overweight
He weighs more than 20 kilos above his ideal body weight.
BMI
You have a Body Mass Index (BMI) greater than 30 kg/m².
Health
You suffer from obesity-related health problems, such as hypertension or diabetes.
Diets
You cannot achieve a healthy body weight, even with medically supervised diets.
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