Weight-Loss Surgery With One Small Incision

Stomach banding is an important weapon in the war chest of the bariatric surgeon - but it typically requires five incisions and a considerable recovery time. But a new technique just coming into use needs just a single incision to accomplish the task of gastric banding, that is, tying off the top portion of the stomach so that food flow is restricted and slowed down. When the small, top part of the stomach is full, it signals the brain, which tells the body it's no longer hungry. This can lead to large reductions in weight for the morbidly obese, who are the only category of patients allowed to undergo the surgery.

With the new procedure, a single incision is made in the navel. Therefore, it's not surprising that the new surgery is called single-incision laparoscopic surgery (SILS). Laparoscopic refers to a device with a video camera attached that's inserted through the incision to allow the doctor to see inside the abdominal cavity.

"SILS is an important new option that holds the potential of less pain, fewer scars and quicker recovery," explained Shawn Garber, chief of bariatric surgery at Mercy Medical Center on Long Island, who also heads the New York Bariatric Group. "And most patients report that they can barely notice the single incision hidden in the bellybutton." The procedure is completed using a special camera to see around obstructions and special graspers with a curved tip.

"There's a current revolution in minimally invasive surgery: Can we make laparoscopic surgery better by decreasing the number of incisions?" said Dr. Daniel Scott, associate professor of surgery and director of the Center for Minimally Invasive Surgery at University of Texas Southwestern Medical Center. "The theory behind this, not yet proven, is that fewer scars are better cosmetically and for pain control. The pain may be less because you alleviate additional cuts, and therefore the recovery may be hastened."

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