Skip to main content
SpringerLink
Log in

Sils without Frills

  • Review Article
  • Published:
Indian Journal of Surgery Aims and scope Submit manuscript

Abstract

Historically, invasive, large incisions were necessary to perform “open” abdominal surgical procedures. While effective, this method increased the possibility of multiple complications, including post-operative pain, wound infection, incisional hernia and prolonged hospitalization. Concerns over the rate of complications and morbidities led surgeons to develop laparoscopic surgical techniques, in which operations in the abdomen are performed through small incisions as opposed to larger, open incisions across the surgical site. There was a continuous effort to minimize the number of ports, and finally single incision laparoscopic surgery (SILS) came into practice. Sils without frills is a concept where multiple ports are made in a curved 2.5 cm incision in a triangle. The chopstick method is used to minimize instrument and telescope clash during the procedure. Standard laparoscopic instruments are introduced along with a 30 ° telescope. Instrument clashes are avoided by chop stick technique of crossing them at a proximal point so that ends are away from each other. Dissection takes place in forward backward movement after making lateral retraction by the other instrument. With experience the operative time is expected to become comparable with conventional laparoscopic cholecystectomy. But benefits regarding post operative pain in SILS has not been confirmed. It is felt that expertise and reduction of operative time may reduce post operative pain. No special telescopes, ports or hand instruments are needed for this procedure but may have a role in advanced laparoscopic procedures.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6
Fig. 7
Fig. 8

Similar content being viewed by others

References

  1. Johnson CD (2001) ABC of the upper gastrointestinal tract upper abdominal pain: gall bladder. Br Med J 323:1170–1173

    Article  CAS  Google Scholar 

  2. Pelosi MA, Pelosi MA (1992) Laparoscopic appendectomy using a single umbilical puncture (minilaparoscopy). J Reprod Med 37:588–594

    PubMed  CAS  Google Scholar 

  3. Navarra G, Pozza E, Occhionorelli S, Carcoforo P, Donini I (1997) One-wound laparoscopic cholecystectomy. Br J Surg 84:695

    Article  PubMed  CAS  Google Scholar 

  4. Piskun G, Rajpal S (1999) Transumbilical laparoscopic cholecystectomy utilizes no incisions outside the umbilicus. J Laparoendosc Adv Surg Tech 9:361–364

    Article  CAS  Google Scholar 

  5. Bresadola F, Pasqualucci A, Donini A et al (1999) Elective transumbilical compared with standard laparoscopic cholecystectomy. Eur J Surg 165(1):29–34

    Article  PubMed  CAS  Google Scholar 

  6. Wheeless CR (1969) A rapid, inexpensive and effective method of surgical sterilization by laparoscopy. J Reprod Med 3(5):65–69

    Google Scholar 

  7. Thompson B, Wheeless RC (1971) Outpatient sterilization by laparoscopy. A report of 666 patients. Obstet Gynecol 38(6):912–915

    PubMed  CAS  Google Scholar 

  8. Tacchino R, Greco F, Matera D (2009) Single-incision laparoscopic cholecystectomy: surgery without a visible scar. Surg Endosc 23:896–899

    Article  PubMed  CAS  Google Scholar 

  9. Cuesta MA, Berends F, Veenhof AA (2008) The “invisible cholecystectomy”: a transumbilical laparoscopic operation without a scar. Surg Endosc 22:1211–1213

    Article  PubMed  Google Scholar 

  10. Hong TH, You YK, Lee KH (2009) Transumbilical single-port laparoscopic cholecystectomy: scarless cholecystectomy. Surg Endosc 23:1393–1397

    Article  PubMed  Google Scholar 

  11. Kurpiewski W, Pesta W, Kowalczyk M, Głowacki L, Juśkiewicz W (2009) SILS cholecystectomy—our first experiences. Videosurg Minim Invasive Tech 4(3):91–94

    Google Scholar 

  12. Romanelli JR, Mark L, Omotosho PA (2008) Single port laparoscopic cholecystectomy with the TriPort system: a case report. Surg Innov 15:223–228

    Article  PubMed  Google Scholar 

  13. Merchant AM, Cook MW, White BC, Davis SS, Sweeney JF, Lin E (2009) Transumbilical Gelport access technique for performing single incision laparoscopic surgery (SILS). J Gastrointest Surg 13:159–162

    Article  PubMed  Google Scholar 

  14. Chow A, Purkayastha S, Aziz O, Paraskeva P (2010) Single-incision laparoscopic surgery for cholecystectomy: an evolving technique. Surg Endosc 24:709–714

    Article  PubMed  Google Scholar 

  15. Love KM, Durham CA, Meara MP, Mays AC, Bower CE (2011) Single-incision laparoscopic cholecystectomy: a cost comparison. Surg Endosc 25(5):1553–1558

    Article  PubMed  Google Scholar 

  16. Marescaux J, Dallemagne B, Perretta S, Wattiez A, Mutter D, Coumaros D (2007) Surgery without scars: report of transluminal cholecystectomy in a human being. Arch Surg 142:823–826, discussion 826-827

    Article  PubMed  Google Scholar 

  17. Ishikawa N, Arano Y, Shimizu S, Morishita M, Kawaguchi M, Matsunoki A, Adachi I, Shimizu J, Watanabe G (2009) Single incision laparoscopic surgery (SILS) using cross hand technique. Minim Invasive Ther Allied Technol 18:322–324

    Article  PubMed  Google Scholar 

  18. Kuon Lee S, You YK, Park JH, Kim HJ, Lee KK, Kim DG (2009) Single-port transumbilical laparoscopic cholecystectomy: a preliminary study in 37 patients with gallbladder disease. J Laparoendosc Adv Surg Tech A 19:495–499

    Article  PubMed  Google Scholar 

  19. Ersin S, Firat O, Sozbilen M (2010) Single-incision laparoscopic cholecystectomy: is it more than a challenge? Surg Endosc 24:68–71

    Article  PubMed  Google Scholar 

  20. Cugura JF, Janković J, Kulis T, Kirac I, Beslin MB (2008) Single incision laparoscopic surgery (SILS) cholecystectomy: where are we? Acta Clin Croat 47:245–248

    PubMed  Google Scholar 

  21. Prasad A (2010) Single incision laparoscopic surgery. World J Gastroenterol 16:2705–2706

    Article  PubMed  Google Scholar 

  22. Prasad A, Kaul S, Mukherjee K, Kaur M (2011) Post operative pain after cholecystectomy: conventional laparoscopy versus single incision laparoscopic surgery. J Min Access Surg 7:24–27

    CAS  Google Scholar 

  23. Tsimoyiannis EC, Tsimogiannis KE, Pappas-Gogos G et al (2010) Different pain scores in single transumbilical incision laparoscopic cholecystectomy versus classic laparoscopic cholecystectomy: a randomized controlled trial. Surg Endosc 24(8):1842–1848

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Delhi, India

    Arun Prasad & Mandeep Kaur

Authors
  1. Arun Prasad
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Mandeep Kaur
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Arun Prasad.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Prasad, A., Kaur, M. Sils without Frills. Indian J Surg 74, 270–273 (2012). https://doi.org/10.1007/s12262-012-0591-8

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12262-012-0591-8

Keywords

Search

Navigation