Laparoscopic surgery cuts down on incisions

Minimally invasive surgery is even more minimal now that doctors at Baylor College of Medicine are using only one incision for some procedures, leaving behind little to no scar.

"This technique has been around for a couple of years. What we are doing now is expanding the types of surgeries for which we can use this method and understanding the benefits in a research setting," said Dr Vadim Sherman, assistant professor of surgery and director of the Comprehensive Bariatric Surgery Center at BCM.

Belly button

One-incision surgeries use the same type of devices as traditional laparoscopic surgeries. However, instead of making up to four or more incisions in the stomach and abdomen area, only one is made through the belly button.

"The belly button is easy to access regardless of a person’s weight and it’s centrally located on the body, making it easy to reach many different organs," Sherman said. "The umbilical ring can be slightly expanded, allowing multiple instruments to be inserted at once."

While this technique is safe, the benefits over traditional laparoscopy have not yet been defined, other than doctor and patient word of mouth. Sherman and his colleagues are detailing all aspects of one-incision surgeries from how it affects surgery time for different conditions, to recovery issues such as healing and pain.

Less scarring

"We are also looking at how we can redesign, if necessary, the tools we use for this procedure," Sherman said. "From my patient’s reaction, it seems the recovery process is equivalent to or better than the regular laparoscopic surgery."

The most obvious benefit is less scarring. While there may be a scar left behind, it is located in the belly button and is usually hidden.

Sherman has used this technique to remove appendixes, gallbladders, feeding tubes and, more recently, some obstetrical-related surgeries. He is also adapting the techniques to certain weight loss procedures.

"While this is becoming a more commonly used surgery technique, our goal is to make sure we evaluate and review all aspects to continue to improve upon patient care," Sherman said.

(Source: Baylor College of Medicine: November 2009)