What Is a Single Incision?

A single incision refers to a type of surgery, also called a single incision laparoscopic surgery (SILS™). This is a surgical procedure that is performed entirely through one cut, made to allow the use of laparoscopic instruments. It is the procedure of choice in many cases, since it has reduced pain and healing time when compared to many other types of surgery. SILS™ is minimally invasive and leaves only a small scar, often barely visible once it is healed.

Single incision surgery can be used to treat many different conditions, typically any that can be treated using laparoscopic techniques requiring multiple incisions. Some of the more common uses for the SILS™ method are gall bladder removal, gynecological surgery, and bariatric surgery. This method is normally not used for any type of emergency surgery, but may be used in many cases of elective procedures. Depending on the purpose of the operation, the use of single incision surgery may be limited to patients who have not had surgery previously.

In a typical SILS™ operation, a 0.75 inch (20 mm) incision is made directly through the umbilicus, or belly button. An access port is placed in the opening and all instruments used for the surgery go into the abdomen through this port. The abdomen is normally inflated with air to allow for easy viewing of the organs via a small, lighted camera on a flexible shaft.

The instruments used during a single incision surgery typically have very long, extended handles. Both the handles and the instruments themselves are quite small, in order to allow them to fit easily through the surgical port. They often have plasticized or rubberized grips in order to make it easy for the surgeon to maintain a firm grasp throughout the procedure.

Patients can benefit from the use of single incision surgery in two main ways. The first way is the reduction in the number of areas that have to heal after surgery. Since there is only one opening, there is typically less pain and only a single site to be cared for. This is particularly important in bariatric surgery, since obese patients have a higher risk of complications at the site of the incision due to breakdown of the fat tissue after surgery.

Another benefit that is important to many people is the lack of a visible scar after surgery. Since the opening for single incision surgery is usually made directly through the belly button, it is disguised after it heals and is normally not noticeable. Conventional laparoscopic surgery typically requires four incisions, and each one creates pain, requires monitoring after the operation, and will leave at least a small scar once healed.