12 February, 2010
Risha Chitlangia
New Delhi, India
Doctors Now Make Single Incision To Remove Gall Stones, Appendix
Four small incisions are made on the abdomen through which a telescope and three surgical instruments are moved inside the tummy to remove the gall bladder or appendix Time taken: 15–30 min Cost: Rs 30,000–Rs 40,000
In this, a single incision is made on the skin, mainly in the navel, and all the instruments are inserted through this port. Three punctures are made in the sheath containing the organs. The instruments are then separated inside the abdomen to give flexibility to the surgeon to remove the affected organ Times taken: 45 minutes–1 hour Size of incision on the skin: 2 cm Cost: Rs 35,000– Rs 40,000
Number of single-incision surgeries done so far at Apollo Hospital: 27 (gall bladder and appendix removals)
The first thought that came to Adwita Pathak’s mind when told that surgery was the only way out of her gall bladder stone problem was her body would be riddled with scars. Having seen the scars on her mother’s stomach following a laparoscopic gall stone removal operation a few months, the 16–year–old refused to go through the surgery even though it was the only option. When doctors at Indraprastha Apollo Hospital told her that the scars won’t be visible, she refused to believe. Finally, she gave in.
On January 4, she underwent a single–incision laparoscopic surgery (SILS) in which doctors made a small incision in her navel to pull out the diseased gall bladder. And voila! There were no scars.
“I have undergone the same operation and have scars on my stomach. So, I just could not believe my eyes when I saw that the scar on my daughter’s body was not visible. We are ecstatic with the result,” Adwita’s mother Sharda Pathak said.
Adwita is one of the 27 people who have been successfully operated at Apollo Hospital using the single–incision laparoscopic surgery technique.
Laparoscopic cholecystectomy is currently the standard mode of treatment for gall stones which is a common problem in India.
“Young people, especially women, don’t want any scar on their bodies. The traditional laparoscopic procedure leaves at least four scars on the abdomen as we have to introduce a telescope and three surgical instruments in the abdominal cavity,” Dr Arun Prasad, senior consultant surgeon, minimally invasive surgery, Apollo Hospital, said.
In SILS, a small 2 cm incision is made in the navel through which all the instruments, including a telescope, are introduced in the abdominal cavity. Three holes are made on the sheath of the abdominal cavity and the instruments are then pushed through these holes. “On the skin surface, there is just one cut visible, but underneath we make three punctures. This allows us more flexibility inside the abdomen,” Dr Prasad said.
Though there are sophisticated instruments available – which can bend at different angles inside the abdomen – for this procedure, Dr Prasad prefers the ones used in traditional laparoscopic surgery. “These sophisticated instruments are expensive. That’s why we decided to used the regular instruments. It takes a little longer to operate, but cost wise doesn’t pinch the patient’s pocket and is scarless,” said Dr Prasad, who has also removed appendixes using the same technique.
According to Dr Prasad, “This is the future of laparoscopy. For routine procedures such as gall bladder stones, appendix, kidney, uterus problems etc this can be beneficial. So far, we have operated just gall bladder and appendix using this technique.”
Flexible Port Enables Feat
In the last two decades, laparascopic procedures have become common. A majority of surgeries, mainly gall bladder and appendix removal, are performed using this technique. Doctors are now performing scarless, single–incision laparoscopy surgery
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