"There's a current revolution in minimally invasive surgery: Can we make laparoscopic surgery better by decreasing the number of incisions?" stated Dr. Daniel Scott, associate professor of surgery and director of the Center for Minimally Invasive Surgery at UT Southwestern. "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."
The trend has taken two paths. With SILS, or single-incision laparoscopic surgery, surgeons make one incision instead of several through the abdominal wall. NOTES, or natural orifice transluminal endoscopic surgery, involves instrumentation access through an existing orifice such as the mouth, colon or vagina.
"SILS may be an appropriate compromise between conventional laparoscopic surgery that uses multiple incisions and multiple access ports, and NOTES, which strives to do away with all incisions on the abdominal wall and go through alternative natural access points of the body and therefore hide all the scars", Dr. Scott stated.
Dr. Scott and Dr. Homero Rivas, assistant professor of surgery, completed the two-and-a-half-hour procedure April 1 at UT Southwestern University Hospital - Zale Lipshy. Surgeons used a special camera to see around obstructions and special graspers with a curved tip. "We have a track record of innovations here", Dr. Scott stated.
UT Southwestern surgeons were the first in a three-state area to perform laparoscopic gastric-bypass surgeries in the late 1990s. They also performed the region's first Lap-Band procedures.
UT Southwestern surgeons have achieved several firsts in single-incision surgery, including the United States' first single-incision kidney removal, North Texas' first single-incision gallbladder surgery and the first single-incision hysterectomy in Durango, Mexico. UT Southwestern surgeons have also performed single-incision colectomies and appendectomies.
UT Southwestern surgeons are part of a national group evaluating the feasibility and safety of single-incision surgeries and have a joint academic venture with surgeons in Shanghai, China, to develop the techniques.
UT Southwestern's Center for Minimally Invasive Surgery has been named a Bariatric Surgery Center of Excellence by the American Society for Bariatric Surgery and is one of only 27 facilities in North America, and the only one in Texas, to be accredited by the American College of Surgeons for its $2 million training lab.
The surgeons at UT Southwestern's Clinical Center for the Surgical Management of Obesity perform more than 350 bariatric and related procedures annually in addition to overseeing more than 1500 annual clinic visits.