Single-incision laparoscopically assisted colectomy using standard laparoscopic instrumentation

• Published in: Surgical endoscopy Vol. 24; no. 4; pp. 888 - 890
• Main Authors: Rieger, Nicholas A., Lam, Francis F.
• Format: Journal Article
• Language: English
• Published: New York Springer-Verlag 01.04.2010; Springer; Springer Nature B.V
• Subjects: Abdominal Surgery; Aged; Aged, 80 and over; Biological and medical sciences; Body mass index; Cancer; Catheters; Colectomy - methods; Colon; Colorectal Neoplasms - surgery; Digestive system. Abdomen; Dissection; Endoscopy; Female; Gastroenterology; Gynecology; Hepatology; Histopathology; Humans; Investigative techniques, diagnostic techniques (general aspects); Laparoscopes; Laparoscopy; Laparoscopy - methods; Length of stay; Length of Stay - statistics & numerical data; Lymph Node Excision; Lymphatic system; Male; Medical sciences; Medicine; Medicine & Public Health; Middle Aged; Miscellaneous; Pathology; Patients; Proctology; Prospective Studies; Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects); Small intestine; Stomach, duodenum, intestine, rectum, anus; Surgery; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Surgery of the digestive system; Surgical Instruments; Treatment Outcome; Tumors; Australia; United States > US; South Australia Australia; Single incision; Colectomy; SILS; Endoscopic surgery; Treatment; Instrumentation; Laparoscopy; Endoscopy; Colon; Standards
• ISSN: 0930-2794; 1432-2218
• DOI: 10.1007/s00464-009-0683-0

Background A prospective case series of transumbilical single-incision laparoscopic colectomies using conventional laparoscopic trocars and instruments is described. Methods Seven selected patients with colonic neoplasm underwent transumbilical SIL colectomy between November 2008 and March 2009. Three trocars via a single small umbilical incision were used. The bowel was mobilized and the vessels ligated intracorporeally with an extracorporeal anastomosis. Results This series of seven patients (6 men and 1 woman) had no conversion to standard multiport laparoscopy or open surgery. Six of the patients had pathology in the right colon, and one had a carcinoma at the splenic flexure. The patients had an average age of 71 years (range, 63–83 years) and an average body mass index (BMI) of 24.3 kg/m 2 (range, 21–28 kg/m 2 ). The average operating time was 89 min (range, 75–115 min). No significant blood loss or complications occurred. The average length of hospital stay was 5.4 days (range, 4–11 days). The average incision length was 3.1 cm (range, 2.5–4.5 cm). Histopathology showed adequate tumor excision margins and an average lymph node yield of 15 nodes (range, 7–26 nodes). Conclusions Single-incision laparoscopic surgery for colectomy is feasible. It can be performed without specialized instrumentation and at no extra cost. Further evaluation is required.