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Single-Incision Laparoscopic Surgery (SILS)

Advanced minimally invasive technique using a single transumbilical port to perform abdominal surgery (cholecystectomy, appendectomy, colectomy, gynecologic operations) with improved cosmesis and reduced wound complications, requiring specialized articulating instruments and surgical expertise.

Written by: Saygı Hospital Health Guide Editorial Board
Last updated:

This content has been compiled by the Saygı Hospital Health Guide Editorial Board and is periodically reviewed by a specialist physician.

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This content is for informational purposes only and does not constitute medical advice. You can book an appointment at our Genel Cerrahi department. Book Appointment →

What is Single-Incision Laparoscopic Surgery (SILS)?

Single-incision laparoscopic surgery (SILS), also called single-port access (SPA) or laparoendoscopic single-site surgery (LESS), is a minimally invasive technique in which all laparoscopic instruments and the camera enter the abdomen through one small incision, typically at the umbilicus, using a multichannel port (e.g., SILS port, GelPort, X-Cone).

Indications include cholecystectomy, appendectomy, colectomy, sleeve gastrectomy, hysterectomy, adrenalectomy, splenectomy, nephrectomy, and selected pediatric operations, with the goals of improved cosmesis, reduced wound morbidity, and shorter hospital stay compared to multiport laparoscopy.

Technical challenges include instrument crowding, loss of triangulation, and limited ergonomics, addressed by curved or articulating instruments, flexible-tip cameras, and dedicated training; outcomes are equivalent to standard laparoscopy for many procedures in expert hands.

Symptoms

Procedure-specific symptoms in the underlying surgical condition (cholelithiasis, appendicitis, colon polyp, fibroid uterus, etc.)
Postoperative umbilical incision pain, generally less than multiport laparoscopy in some series
Possible early seroma or hematoma at the umbilical wound
Risk of incisional hernia at the larger umbilical fascial defect requiring meticulous closure
Postoperative shoulder pain from CO2 pneumoperitoneum (similar to standard laparoscopy)
Procedure-specific complications (e.g., bile duct injury during cholecystectomy, anastomotic leak after colectomy)

Risk Factors

Severe obesity (high body mass index) limiting reach and triangulation through a single port
Prior abdominal surgery with adhesions complicating umbilical access and visualization
Large or inflammatory mass requiring extensive dissection and instrument freedom
Limited surgeon experience with single-port technique increasing operative time and complication risk
Anesthesia and cardiopulmonary risk for prolonged pneumoperitoneum
Anatomic variants (e.g., portal hypertension, severe umbilical hernia) limiting safe single-incision access

When to See a Doctor?

If you experience any of the following symptoms, seek medical attention promptly:

  • Patient interested in scarless surgery for cholecystectomy, appendectomy, or other elective operation — surgical consultation regarding SILS suitability
  • Postoperative wound concerns: bleeding, infection, persistent serous drainage, bulging — surgical review
  • Postoperative incisional hernia at umbilical site — surgical assessment for repair
  • Significant postoperative pain unresponsive to standard analgesia, fever, or peritonitis features — emergency evaluation
  • Long-term scar dissatisfaction — plastic surgery or scar revision consultation

Treatment Methods

01
Preoperative selection: BMI, prior surgery, expected operative complexity, and patient cosmesis priorities; comprehensive informed consent including possible conversion to multiport or open
02
Single multichannel port at umbilicus, articulating or curved instruments, flexible high-definition camera, and external triangulation strategies
03
Procedure-specific dissection following standard oncologic or general surgical principles, with care to avoid instrument clashing and maintain visualization
04
Robotic single-port platforms (e.g., da Vinci SP) can overcome ergonomic limitations and expand SILS to complex cases (radical prostatectomy, partial nephrectomy, cholecystectomy)
05
Postoperative care: enhanced recovery protocols, early mobilization, multimodal analgesia, careful umbilical closure to reduce hernia risk, and patient education on scar care

Which Department to Visit?

You can visit our Genel Cerrahi department for these complaints. Our specialist physicians will create the most suitable treatment plan for you.

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Related Health Topics

Other articles from the same department you may want to explore.

Appendicitis

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Appendicitis is inflammation of the appendix causing severe pain in the lower right abdomen. Early diagnosis and surgical treatment are life-saving.

Inguinal Hernia

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Inguinal hernia is the protrusion of intestine or fat into the inguinal canal due to weakness in the abdominal wall. It can be permanently corrected with surgical treatment.

Umbilical Hernia

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Umbilical hernia manifests as a soft swelling around the navel. While it often resolves spontaneously in infants, surgical treatment may be required in adults.

Gallstones and Cholecystectomy

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Gallstones cause severe pain in the upper right abdomen, especially after fatty meals. They are safely treated with laparoscopic cholecystectomy.

Hemorrhoids (Piles)

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Hemorrhoids result from swelling of the veins in the anus; they present with blood on toilet paper, itching, and pain. Various treatments are available, from lifestyle changes to surgery.

Anal Fissure

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Anal fissure is a tear in the thin skin of the anal canal. It presents with sharp pain and bleeding and can be healed with medical or surgical treatment.

Pilonidal Sinus

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Pilonidal sinus consists of tunnels and tracts prone to chronic infection, formed by hair becoming embedded under the skin in the tailbone area. Surgical treatment provides a permanent solution.

Thyroid Surgery

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Thyroid surgery involves the removal of part or all of the thyroid gland for indications such as benign nodules, goiter, and thyroid cancer.

Health Disclaimer: The information on this page is prepared for general informational purposes only. It does not replace medical diagnosis and treatment. Please consult your physician for your complaints. Saygı Hospital does not accept responsibility for actions taken based on the information on this page.