Skip to main content

Advertisement

SpringerLink
Log in

Safety, Feasibility, and Short-Term Outcomes of Single Port Access Colorectal Surgery: A Single Institutional Case-Matched Study

  • Original Article
  • Published:
Journal of Gastrointestinal Surgery Aims and scope

Abstract

Background

Feasibility of single port access (SPA) colorectal surgery has been established for various procedures from ileocecal resection to proctectomy. Nevertheless, its benefits compared to conventional laparoscopy still need to be assess. The aim of this study was to compare SPA to conventional colorectal laparoscopic surgery in a single institutional case-matched study.

Methods

From July 2009 to July 2010, 25 SPA colorectal resections were matched on main predictive risk factors of postoperative complications, in a one to two fashion, with patient having the same procedure for the same indication by conventional laparoscopy.

Results

Patient characteristics were comparable between both groups. SPA was successfully performed in 24 of 25 patients, with a need to conversion to standard laparoscopy in one case (4%). SPA was associated with a significantly shorter median operative time (130 vs 180 min, p = 0.04) and hospital stay (6 vs 7 days, p = 0.005). Postoperative morbidity rates were similar between the two groups (4% vs 16%, p = 0.25).

Conclusion

SPA colorectal resection can be safely performed in selected patients with results comparable to those observed after conventional laparoscopic surgery. However, larger studies including randomized controlled trail are needed to demonstrate possible benefits of SPA colorectal resection over conventional colorectal laparoscopic surgery.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Bucher P, Pugin F, Morel P (2008) Single port access laparoscopic right hemicolectomy. Int J Colorectal Dis 23:1013–1016

    Article  PubMed  Google Scholar 

  2. Bucher P, Pugin F, Morel P (2010) Transumbilical single incision laparoscopic sigmoidectomy for benign disease. Colorectal Dis 12:61–65

    Article  PubMed  CAS  Google Scholar 

  3. Ostrowitz MB, Eschete D, Zemon H, DeNoto G (2009) Robotic-assisted single-incision right colectomy: early experience. Int J Med Robot 5:465–470

    Article  PubMed  Google Scholar 

  4. Remzi FH, Kirat HT, Kaouk JH, Geisler DP (2008) Single-port laparoscopy in colorectal surgery. Colorectal Dis 10:823–826

    Article  PubMed  CAS  Google Scholar 

  5. Merchant AM, Lin E (2009) Single-incision laparoscopic right hemicolectomy for a colon mass. Dis Colon Rectum 52:1021–1024

    Article  PubMed  Google Scholar 

  6. Leroy J, Cahill RA, Asakuma M, Dallemagne B, Marescaux J (2009) Single-access laparoscopic sigmoidectomy as definitive surgical management of prior diverticulitis in a human patient. Arch Surg 144:173–179; discussion 179

    Article  PubMed  Google Scholar 

  7. Rieger NA, Lam FF (2010) Single-incision laparoscopically assisted colectomy using standard laparoscopic instrumentation. Surg Endosc 24:888–890

    Article  PubMed  Google Scholar 

  8. Bucher P, Pugin F, Morel P (2009) Single-port access laparoscopic radical left colectomy in humans. Dis Colon Rectum 52:1797–1801

    Article  PubMed  Google Scholar 

  9. Geisler DP, Condon ET, Remzi FH (2010) Single incision laparoscopic total proctocolectomy with ileopouch anal anastomosis. Colorectal Dis 12:941–943

    Article  PubMed  CAS  Google Scholar 

  10. Law WL, Fan JK, Poon JT (2010) Single incision laparoscopic left colectomy for carcinoma of distal transverse colon. Colorectal Dis 12:698–701

    Article  PubMed  Google Scholar 

  11. Remzi FH, Kirat HT, Geisler DP (2010) Laparoscopic single-port colectomy for sigmoid cancer. Tech Coloproctol 14:253–255

    Article  PubMed  CAS  Google Scholar 

  12. Law WL, Fan JK, Poon JT (2010) Single-incision laparoscopic colectomy: early experience. Dis Colon Rectum 53:284–288

    Article  PubMed  Google Scholar 

  13. Chambers W, Bicsak M, Lamparelli M, Dixon A (2011) Single-incision laparoscopic surgery (SILS) in complex colorectal surgery: a technique offering potential and not just cosmesis. Colorectal Dis 13;393–8

    Google Scholar 

  14. Ross H, Steele S, Whiteford M, Lee S, Albert M, Mutch M, Rivadeneira D, Marcello P (2011) Early multi-institution experience with single-incision laparoscopic colectomy. Dis Colon Rectum 54:187–192

    Article  PubMed  CAS  Google Scholar 

  15. Pfluke JM, Parker M, Stauffer JA, Paetau AA, Bowers SP, Asbun HJ, Smith CD (2011) Laparoscopic surgery performed through a single incision: a systematic review of the current literature. J Am Coll Surg 212:113–118

    Article  PubMed  Google Scholar 

  16. Leblanc F, Makhija R, Champagne BJ, Delaney CP (2011) Single incision laparoscopic total colectomy and proctocolectomy for benign disease-Initial experience. Colorectal Dis 13;1290–3

    Google Scholar 

  17. Keshava A, Young CJ, Mackenzie S (2010) Single-incision laparoscopic right hemicolectomy. Br J Surg 97:1881–1883

    Article  PubMed  CAS  Google Scholar 

  18. Boni L, Dionigi G, Cassinotti E, Di Giuseppe M, Diurni M, Rausei S, Cantore F, Dionigi R (2010) Single incision laparoscopic right colectomy. Surg Endosc 24:3233–3236

    Article  PubMed  Google Scholar 

  19. Ahmed K, Wang TT, Patel VM, Nagpal K, Clark J, Ali M, Deeba S, Ashrafian H, Darzi A, Athanasiou T, Paraskeva P (2011) The role of single-incision laparoscopic surgery in abdominal and pelvic surgery: a systematic review. Surg Endosc 25:378–396

    Article  PubMed  Google Scholar 

  20. Ramos-Valadez DI, Patel CB, Ragupathi M, Bartley Pickron T, Haas EM (2010) Single-incision laparoscopic right hemicolectomy: safety and feasibility in a series of consecutive cases. Surg Endosc 24:2613–2616

    Article  PubMed  Google Scholar 

  21. Fronza JS, Linn JG, Nagle AP, Soper NJ (2010) A single institution’s experience with single incision cholecystectomy compared to standard laparoscopic cholecystectomy. Surgery 148:731–734; discussion 734–736

    Article  PubMed  Google Scholar 

  22. Lee PC, Lo C, Lai PS, Chang JJ, Huang SJ, Lin MT, Lee PH (2010) Randomized clinical trial of single-incision laparoscopic cholecystectomy versus minilaparoscopic cholecystectomy. Br J Surg 97:1007–1012

    Article  PubMed  Google Scholar 

  23. Tsimoyiannis EC, Tsimogiannis KE, Pappas-Gogos G, Farantos C, Benetatos N, Mavridou P, Manataki A (2010) Different pain scores in single transumbilical incision laparoscopic cholecystectomy versus classic laparoscopic cholecystectomy: a randomized controlled trial. Surg Endosc 24:1842–1848

    Article  PubMed  Google Scholar 

  24. Chow A, Purkayastha S, Nehme J, Darzi LA, Paraskeva P (2010) Single incision laparoscopic surgery for appendicectomy: a retrospective comparative analysis. Surg Endosc 24:2567–2574

    Article  PubMed  Google Scholar 

  25. Raman JD, Bagrodia A, Cadeddu JA (2009) Single-incision, umbilical laparoscopic versus conventional laparoscopic nephrectomy: a comparison of perioperative outcomes and short-term measures of convalescence. Eur Urol 55:1198–1204

    Article  PubMed  Google Scholar 

  26. Canes D, Berger A, Aron M, Brandina R, Goldfarb DA, Shoskes D, Desai MM, Gill IS (2010) Laparo-endoscopic single site (LESS) versus standard laparoscopic left donor nephrectomy: matched-pair comparison. Eur Urol 57:95–101

    Article  PubMed  Google Scholar 

  27. Gandhi DP, Ragupathi M, Patel CB, Ramos-Valadez DI, Pickron TB, Haas EM (2010) Single-incision versus hand-assisted laparoscopic colectomy: a case-matched series. J Gastrointest Surg 14:1875–1880

    Article  PubMed  Google Scholar 

  28. Champagne BJ, Lee EC, Leblanc F, Stein SL, Delaney CP (2011) Single-incision vs straight laparoscopic segmental colectomy: a case-controlled study. Dis Colon Rectum 54:183–186

    Article  PubMed  CAS  Google Scholar 

  29. Waters JA, Guzman MJ, Fajardo AD, Selzer DJ, Wiebke EA, Robb BW, George VV (2010) Single-port laparoscopic right hemicolectomy: a safe alternative to conventional laparoscopy. Dis Colon Rectum 53:1467–1472

    Article  PubMed  Google Scholar 

  30. Adair J, Gromski MA, Lim RB, Nagle D (2010) Single-incision laparoscopic right colectomy: experience with 17 consecutive cases and comparison with multiport laparoscopic right colectomy. Dis Colon Rectum 53:1549–1554

    Article  PubMed  Google Scholar 

  31. Chen WT, Chang SC, Chiang HC, Lo WY, Jeng LB, Wu C, Ke TW (2011) Single-incision laparoscopic versus conventional laparoscopic right hemicolectomy: a comparison of short-term surgical results. Surg Endosc 25:1887–1892

    Article  PubMed  Google Scholar 

  32. Papaconstantinou HT, Sharp N, Thomas JS (2011) Single-incision laparoscopic right colectomy: a case-matched comparison with standard laparoscopic and hand-assisted laparoscopic techniques. J Am Coll Surg 213:72–80

    Article  PubMed  Google Scholar 

  33. Gaujoux S, Bretagnol F, Ferron M, Panis Y (2011) Single incision laparoscopic colonic surgery (SILS). Colorectal Dis 13(9):1066–1071

    Google Scholar 

  34. Alves A, Panis Y, Bouhnik Y, Pocard M, Vicaut E, Valleur P (2007) Risk factors for intra-abdominal septic complications after a first ileocecal resection for Crohn’s disease: a multivariate analysis in 161 consecutive patients. Dis Colon Rectum 50:331–336

    Article  PubMed  Google Scholar 

  35. Alves A, Panis Y, Slim K, Heyd B, Kwiatkowski F, Mantion G (2005) French multicentre prospective observational study of laparoscopic versus open colectomy for sigmoid diverticular disease. Br J Surg 92:1520–1525

    Article  PubMed  CAS  Google Scholar 

  36. Bretagnol F, Alves A, Ricci A, Valleur P, Panis Y (2007) Rectal cancer surgery without mechanical bowel preparation. Br J Surg 94:1266–1271

    Article  PubMed  CAS  Google Scholar 

  37. (1995) Physical status: the use and the interpretation of anthropometry: report of a WHO expert committee. World Health Organ Tech Rep Ser:1–452

  38. Alves A, Panis Y, Mathieu P, Mantion G, Kwiatkowski F, Slim K (2005) Postoperative mortality and morbidity in French patients undergoing colorectal surgery: results of a prospective multicenter study. Arch Surg 140:278–283, discussion 284

    Article  PubMed  Google Scholar 

  39. Alves A, Panis Y, Mantion G, Slim K, Kwiatkowski F, Vicaut E (2007) The AFC score: validation of a 4-item predicting score of postoperative mortality after colorectal resection for cancer or diverticulitis: results of a prospective multicenter study in 1049 patients. Ann Surg 246:91–96

    Article  PubMed  Google Scholar 

  40. Dindo D, Demartines N, Clavien PA (2004) Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann Surg 240:205–213

    Article  PubMed  Google Scholar 

  41. Aldrighetti L, Guzzetti E, Ferla G (2011) Laparoscopic hepatic left lateral sectionectomy using the LaparoEndoscopic Single Site approach: evolution of minimally invasive liver surgery. J Hepatobiliary Pancreat Sci 18:103–105

    Article  PubMed  Google Scholar 

  42. Gaujoux S, Kingham TP, Jarnagin WR, D’Angelica MI, Allen PJ, Fong Y (2010) Single-incision laparoscopic liver resection. Surg Endosc

  43. Lee YS, Kim JH, Moon EJ, Kim JJ, Lee KH, Oh SJ, Park SM, Hong TH (2009) Comparative study on surgical outcomes and operative costs of transumbilical single-port laparoscopic appendectomy versus conventional laparoscopic appendectomy in adult patients. Surg Laparosc Endosc Percutan Tech 19:493–496

    Article  PubMed  Google Scholar 

  44. Santos BF, Enter D, Soper NJ, Hungness ES (2011) Single-incision laparoscopic surgery (SILS) versus standard laparoscopic surgery: a comparison of performance using a surgical simulator. Surg Endosc 25:483–490

    Article  PubMed  Google Scholar 

  45. Maeda T, Tan KY, Konishi F, Tsujinaka S, Mizokami K, Sasaki J, Kawamura YJ (2009) Trainee surgeons do not cause more conversions in laparoscopic colorectal surgery if they are well supervised. World J Surg 33:2439–2443

    Article  PubMed  Google Scholar 

Download references

Conflict of Interest

None of the authors have any conflict of interest

Author information

Authors and Affiliations

  1. Department of Colorectal Surgery, Beaujon Hospital, Assistance Publique Hôpitaux de Paris (AP-HP), Paris, France

    Sébastien Gaujoux, Léon Maggiori, Frédéric Bretagnol, Marianne Ferron & Yves Panis

  2. Université Paris VII (Denis Diderot), Clichy, France

    Frédéric Bretagnol & Yves Panis

  3. Service de Chirurgie Colorectale (Pôle des maladies de l’Appareil Digestif)–Hôpital Beaujon, APHP and University Paris VII (Denis Diderot), 100 boulevard du Général Leclerc, 92118, Clichy cedex, France

    Yves Panis

Authors
  1. Sébastien Gaujoux
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Léon Maggiori
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Frédéric Bretagnol
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Marianne Ferron
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Yves Panis
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Yves Panis.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Gaujoux, S., Maggiori, L., Bretagnol, F. et al. Safety, Feasibility, and Short-Term Outcomes of Single Port Access Colorectal Surgery: A Single Institutional Case-Matched Study. J Gastrointest Surg 16, 629–634 (2012). https://doi.org/10.1007/s11605-011-1780-7

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11605-011-1780-7

Keywords

Search

Navigation