Single Incision Lap Band and Gastric Sleeve Gastrectomy

The Lap Band and the Gastric Sleeve Gastrectomy can now potentially be done through a single incision. The ability to do so uses cutting edge technology which falls under the heading of Single Incision Laparoscopic Surgery (SILS) which has been trademarked by Covidian. While recovery after weight loss surgery is not significantly different than conventional multi-incision laparoscopic surgery, the cosmetic results are by far more superior.

Not all patients are candidates for this technique. Patient selection and the laparoscopic experience of the surgeons using this technique are important determinants in not only the ability to perform the procedure but also the safety of the procedure.

Single Incision Sleeve Gastrectomy
Dr. John Gonzalez of the Texas Endosurgery Institute and Texas Bariatric Specialists was the first surgeon in San Antonio to perform this surgery. He and Dr. Patel are now screening patients who will be potential candidates for the single incision Sleeve Gastrectomy. The procedure should last less than 90 minutes and the patient should be able to go home just 2 days after surgery. The principles of the single incision Sleeve Gastrectomy are identical to the conventional laparoscopic approach. The stomach volume is reduced to 20-30% of its original size, the patient is left with a tubular shaped stomach and theoretically reduced hunger sensation secondary to removing the portion of the stomach that makes the hunger hormone.

The ideal candidates for the single incision sleeve gastrectomy:

• Have a body mass index less than 45kg/m2.
• Have had no prior abdominal surgery.
• Do not have a lot of central obesity.

One should note that the single incision concept in bariatric surgery is somewhat of a misnomer as no bariatric procedure can be performed with truly a single incision. In reality, in single incision bariatric surgery, all of the operating is done through a single port/incision but a second incision/port must always be placed in order to move and hold the liver out of the way. Click here for more information about the Sleeve Gastrectomy.

Single Incision Lap Band
The surgeons at Texas Bariatric Specialists do not feel that the present techniques for single incision Lap Band surgery offer substantial benefit over the present 4 incision technique being used. We feel this way since the incision made in single incision surgery is rather large and may be even less cosmetically acceptable than the smaller incisions presently used. The main limitation at present is making an incision through which the Lap Band placement is feasible and can still be used to place the port under the skin at a stable, fixed point. For self-pay patients, single incision surgery would be more expensive. We are continuously evolving as a team of experts and feel that the best of all worlds will be achieved with this technique for the Lap Band in the very near future.

Single Incision Gallbladder Removal
Many patients fear the risk of gallstones after bariatric surgery. The risk in our series is approximately 5-8%. For post-operative patients, single incision gallbladder removal is very possible. Dr. John Gonzalez of Texas Endosurgery Institute and Texas Bariatric Specialists was the first surgeon to remove the gallbladder via a single incision.

Note that any patient may be a candidate for single incision gallbladder removal. The key determinates will be prior surgery history, the nature of the gallbladder disease and the weight of the patient. Call today to see if you are a candidate.

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