C Rajkumar Vinayak
General Hospital Taiping, Malaysia
C Rajkumar Vinayak has completed MBBS from JIPMER, India, MS, Gen. Surg. from Osmania University, India. He completed fellowship in Advanced Lap. & Bariatric Surgery from LOC Pune, India. He is currently practising as Consultant General & Bariatric Surgeon at General Hospital Taiping, Malaysia. He has established bariatric services in Northern region, Malaysia since 2007. He is Principle Investigator in clinical reasearch project: “Identification of Novel Biomarkers in Morbid Obese Patients Undergoing Bariatric Surgery” – in conjuction with Research Councils, UK & Univ Malaya, Malaysia. He is Pioneer in Stapleless Bariatric Surgery in Malaysia. Currently he is Faculty for Asia Pacific Metabolic & Bariatric Surgery Society, College of Surgeons, Malaysia and Malaysian Metabolic & Bariatric Surgery Society-2016.
Single Incision Laparoscopic Sleeve Gastrectomy (SILS) involves a single incision and specialized port platforms to facilitate surgery. SILS is unique and challenging in bariatric surgery due to the thickness of the patient’s abdominal wall. Here we present a video demonstration of a SILS sleeve gastrectomy using the Gelpoint platform with incorporation of needleoscopic-like instruments. Inclusion criteria for our cohort are as per standard NICE guidelines for the asian population. Patients with excessive android habitus, large livers and the super obese (BMI>50) were excluded. A total of 121 bariatric procedures were performed at our centre from may 2015 to may 2016. 5 patients out of 56 sleeve gastrectomies performed requested for SILS. All 5 patients were discharged well by post op day 2-3. Benefits from SILS involve a less invasive approach and minimum visible scarring (achieving close to the scarless effect). Disadvantages include loss of triangulation and cluttering of instruments. Also, surgeons will need to familiarize themselves with the learning curve and demanding techniques. As innovations occur in the SILS platform, a difficult intervention can be made relatively easy, safe and cost effective. In conclusion SILS is a surgical modality, which if performed correctly, brings about results comparable with standard laparoscopy bariatric surgery with the addition of cosmesis and cost-effectiveness.