1 October 2008

NHSG/82/08

'Scarless' surgery pioneered at Aberdeen Royal Infirmary

Aberdeen Royal Infirmary (ARI) has become the first institution in Scotland to perform appendix and gall bladder surgery using a "scarless" technique.

This new technique has been used on eight patients so far. Four patients have had their gall bladder removed and four have had their appendix taken out. The entire procedure was done with only one 10mm incision through the umbilicus ? the belly button. These operations were performed by Mr Irfan Ahmed, Consultant Surgeon in Aberdeen Royal Infirmary, and his senior registrar Mr Euan MacDonald.

"Single port surgery is a major step towards scarless surgery, by using the umbilicus, a scar everyone has from birth? said Mr Ahmed. "It is practical for the surgeon and it appeals to patients, because no one wants a scar if they can avoid it.  At the end of the procedure, the incision line is hidden by the shape of the belly button.  All the patients who were offered this surgery were excited by the idea and delighted with the cosmetic results after surgery."

The new technique involves making an incision through the navel and inserting a port with multiple channels, so that instruments, including a miniature camera, can be fed through to the site of the operation, all through the one access point.  All patients experienced minimal discomfort and have a barely visible scar, compared to traditional laparoscopic procedures requiring three to four incisions "one in the belly button, with the others routinely made through the abdomen at various levels, leaving obvious scarring".

"I read about this procedure being used in the Cleveland clinic in the USA by Urologists early this year to remove part of a kidney, and I thought it could be used for other procedures in general surgery.  So far, I have only heard of one other institution in the UK ".    " Imperial College were doing single port appendectomies just before these procedures at Aberdeen Royal Infirmary."

"The concept builds on keyhole surgery, which has been used routinely since the 90s, but which involves several incisions. The single port surgical technique allows us to do the same procedure we've been doing for the past 15 years, but through fewer incisions and with no added or new complications.  After successfully using this technique on our patients, we are very proud to be leading the way in Aberdeen, said Mr Ahmed. 

Mr Ahmed, who believes this technique can be easily taught to other surgeons, foresees holding training seminars at Aberdeen Royal Infirmary to allow others to offer the procedure to their patients. A trial to look into benefits of this technique is already planned.

He says: "Single-incision laparoscopic surgery still needs to be studied in an academic setting before it becomes widely available. But there is a lot of excitement around this new technique because there is no doubt that this further reduces the invasive nature of surgery. It could replace traditional laparoscopic procedures performed by surgeons and gynaecologists in selected conditions. I see it happening routinely in the next two years."

ENDS

Interview facility

Mr Irfan Ahmed, Consultant Surgeon, Mr Euan MacDonald, Senior Registrar and one of their appendectomy patients will be available for interview at 12 noon on Wednesday 1 October.

Please contact NHS Grampian Corporate Communications, on 01224 554400.