Single Incision Laparoscopic Surgery (SILS)
By
Dr. Ashish Shah
Consultant
General/Gastroenterology/Laparoscopic
Surgery, W...
Anatomy of the Digestive System
Gall Bladder Diseases
Symptoms of Gall Stones
• Abdominal pain – after food
• Back Pain
• Chest pain
• Nausea/Vomiting
• Jaundice
Symptoms of appendicitis
• Abdominal pain – periumbilical/right lower
abdominal pain
• Nausea/Vomiting
• Fever
Laparoscopic Surgery
Conventional Laparoscopic
Cholecystectomy/Appendicectomy
4 Ports (keyhole) for Cholecystectomy & 3 for
Appendicectomy
SILS- A Perspective
• Global:
• Gained popularity in the last 1-2 yrs
• Currently offered at major laparoscopy
centres
• I...
SILS – Single Incision
Laparoscopic Surgery
Laparoscopic surgery through one 20mm incision
(cut) at the umbilicus
SILS – The Procedure
SILS –The Wockhardt
Experience
• 4 months (4/05/09 till date)
• 10 patients – 9 Female pts, 1 Male pt
• 7 Cholecystectomie...
SILS – Wockhardt Experience
• Recovery: In hospital-Ambulation 3 hrs post operation
• Stay: Overnight stay
• Analgesia (Pa...
SILS v/s Conventional
Laparoscopy
• Cosmetically superior
• Lesser pain and decreased need for analgesics
• Earlier recove...
Who can perform SILS?
• Experienced Laparoscopic Surgeons who routinely perform
advanced Laparoscopic surgeries
• For whom...
Way forward…
• SILS-The next big step forward in Laparoscopic
Surgery
• Offers cosmetic benefit and quicker recovery than
...
Thank You
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Single Incision Laparoscopic Surgery

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Advantages of Single Incision Laparoscopic Surgery. medical Breakthroughs via Minimally Invasive surgery

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  • Stem cells are “non-specialized” cells that have the potential to form into other types of specific cells, such as blood, muscles or nerves. They are unlike 'differentiated' cells which have already become whatever organ or structure they are in the body. Stem cells are present throughout our body, but more abundant in a fetus.
    Medical researchers and scientists believe that stem cell therapy will, in the near future, advance medicine dramatically and change the course of disease treatment. This is because stem cells have the ability to grow into any kind of cell and, if transplanted into the body, will relocate to the damaged tissue, replacing it. For example, neural cells in the spinal cord, brain, optic nerves, or other parts of the central nervous system that have been injured can be replaced by injected stem cells. Various stem cell therapies are already practiced, a popular one being bone marrow transplants that are used to treat leukemia. In theory and in fact, lifeless cells anywhere in the body, no matter what the cause of the disease or injury, can be replaced with vigorous new cells because of the remarkable plasticity of stem cells. Biomed companies predict that with all of the research activity in stem cell therapy currently being directed toward the technology, a wider range of disease types including cancer, diabetes, spinal cord injury, and even multiple sclerosis will be effectively treated in the future. Recently announced trials are now underway to study both safety and efficacy of autologous stem cell transplantation in MS patients because of promising early results from previous trials.
    History
    Research into stem cells grew out of the findings of two Canadian researchers, Dr’s James Till and Ernest McCulloch at the University of Toronto in 1961. They were the first to publish their experimental results into the existence of stem cells in a scientific journal. Till and McCulloch documented the way in which embryonic stem cells differentiate themselves to become mature cell tissue. Their discovery opened the door for others to develop the first medical use of stem cells in bone marrow transplantation for leukemia. Over the next 50 years their early work has led to our current state of medical practice where modern science believes that new treatments for chronic diseases including MS, diabetes, spinal cord injuries and many more disease conditions are just around the corner. For more information please visit http://www.neurosurgeonindia.org/
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  • After 6 months of offering stem cell therapy in combination with the venous angioplasty liberation procedure, patients of CCSVI Clinic have reported excellent health outcomes. Ms. Kasma Gianopoulos of Athens Greece, who was diagnosed with the Relapsing/Remitting form of MS in 1997 called the combination of treatments a “cure”. “I feel I am completely cured” says Ms. Gianopoulos, “my symptoms have disappeared and I have a recovery of many functions, notably my balance and my muscle strength is all coming (back). Even after six months, I feel like there are good changes happening almost every day. Before, my biggest fear was that the changes wouldn’t (hold). I don’t even worry about having a relapse anymore. I’m looking forward to a normal life with my family. I think I would call that a miracle.”
    Other recent MS patients who have had Autologous Stem Cell Transplantation (ASCT), or stem cell therapy have posted videos and comments on YouTube. www.youtube.com/watch?v=jFQr2eqm3Cg.
    Dr. Avneesh Gupte, the Neurosurgeon at Noble Hospital performing the procedure has been encouraged by results in Cerebral Palsy patients as well. “We are fortunate to be able to offer the treatment because not every hospital is able to perform these types of transplants. You must have the specialized medical equipment and specially trained doctors and nurses”. With regard to MS patients, “We are cautious, but nevertheless excited by what patients are telling us. Suffice to say that the few patients who have had the therapy through us are noticing recovery of neuro deficits beyond what the venous angioplasty only should account for”.
    Dr. Unmesh of Noble continues: “These are early days and certainly all evidence that the combination of liberation and stem cell therapies working together at this point is anecdotal. However I am not aware of other medical facilities in the world that offer the synthesis of both to MS patients on an approved basis and it is indeed a rare opportunity for MS patients to take advantage of a treatment that is quite possibly unique in the world”.
    Autologous stem cell transplantation is a procedure by which blood-forming stem cells are removed, and later injected back into the patient. All stem cells are taken from the patient themselves and cultured for later injection. In the case of a bone marrow transplant, the HSC are typically removed from the Pelvis through a large needle that can reach into the bone. The technique is referred to as a bone marrow harvest and is performed under a general anesthesia. The incidence of patients experiencing rejection is rare due to the donor and recipient being the same individual.This remains the only approved method of the SCT therapy.
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Single Incision Laparoscopic Surgery

  1. 1. Single Incision Laparoscopic Surgery (SILS) By Dr. Ashish Shah Consultant General/Gastroenterology/Laparoscopic Surgery, Wockhardt Hospitals
  2. 2. Anatomy of the Digestive System
  3. 3. Gall Bladder Diseases
  4. 4. Symptoms of Gall Stones • Abdominal pain – after food • Back Pain • Chest pain • Nausea/Vomiting • Jaundice
  5. 5. Symptoms of appendicitis • Abdominal pain – periumbilical/right lower abdominal pain • Nausea/Vomiting • Fever
  6. 6. Laparoscopic Surgery
  7. 7. Conventional Laparoscopic Cholecystectomy/Appendicectomy 4 Ports (keyhole) for Cholecystectomy & 3 for Appendicectomy
  8. 8. SILS- A Perspective • Global: • Gained popularity in the last 1-2 yrs • Currently offered at major laparoscopy centres • India: • Introduced about 1yr ago in Mumbai • Very few centres offering SILS due to lack of expertise and equipment
  9. 9. SILS – Single Incision Laparoscopic Surgery Laparoscopic surgery through one 20mm incision (cut) at the umbilicus
  10. 10. SILS – The Procedure
  11. 11. SILS –The Wockhardt Experience • 4 months (4/05/09 till date) • 10 patients – 9 Female pts, 1 Male pt • 7 Cholecystectomies – 6 Female, 1 Male • 4 Appendicectomies – 4 Female • Youngest – 21 yrs (Appendicectomy) • Oldest – 62 yrs (Cholecystectomy)
  12. 12. SILS – Wockhardt Experience • Recovery: In hospital-Ambulation 3 hrs post operation • Stay: Overnight stay • Analgesia (Pain medication): Decreased requirement- compared to conventional Laparoscopic • Earlier return to routine activity
  13. 13. SILS v/s Conventional Laparoscopy • Cosmetically superior • Lesser pain and decreased need for analgesics • Earlier recovery • Earlier return to activity • Applicable to many common surgical conditions – GB stones, Appendicitis, Hernia, to name a few
  14. 14. Who can perform SILS? • Experienced Laparoscopic Surgeons who routinely perform advanced Laparoscopic surgeries • For whom: All patients who would need Laparoscopic surgery especially for uncomplicated Gallstones, Appendicitis or Hernia
  15. 15. Way forward… • SILS-The next big step forward in Laparoscopic Surgery • Offers cosmetic benefit and quicker recovery than conventional Laparoscopy • Applicable to patients requiring Laparoscopic procedures for uncomplicated conditions • SILS offered routinely to suitable patients at Wockhardt Hospital, Cunningham Road
  16. 16. Thank You
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