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International Journal of Colorectal Disease

, Volume 29, Issue 12, pp 1501–1505 | Cite as

Needlescopic surgery for left-sided colorectal cancer

  • Toshiki Mukai
  • Yosuke Fukunaga
  • Masashi Ueno
  • Satoshi Nagayama
  • Yoshiya Fujimoto
  • Tsuyoshi Konishi
  • Takashi Akiyoshi
  • Riki Ono
  • Toshiharu Yamaguchi
Original Article

Abstract

Purpose

Laparoscopic surgery has become the standard for colorectal cancers, but more minimally invasive surgery is continuously pursued. In June 2011, our institution started needlescopic surgery (NS). The aims of this study are to describe this technique and to investigate its feasibility for left-sided colorectal cancer surgery.

Methods

From June 2011 to June 2013, 105 sigmoid colon and upper/middle rectal cancer patients underwent NS in our institution, involving one 5-mm port and three 3-mm ports, with the exception of an umbilical 12-mm port. A 10-mm scope is used through the umbilical 12-mm port, which will be extended to a small skin incision for specimen extraction. After dissection of the left colon, a 5-mm scope is inserted through the right lower 5-mm port and a linear stapler is inserted through the umbilical 12-mm port for rectal transection. The specimen is then extracted through umbilical incision, and the anastomosis is carried out by the double-staple technique.

Results

TNM staging is stage 0/I/II/III/IV = 0/31/32/31/11. Fifty-one patients underwent sigmoidectomy and 54 patients underwent anterior resection. There was no conversion to open surgery, but one patient required a change to a 5-mm port from one of the 3-mm ports. Mean operating time was 193 min and mean estimated blood loss was 12 ml. There were ten (9 %) postoperative complications: two anastomotic leaks requiring reoperation, two anastomotic hemorrhages, and one wound infection. There was no mortality.

Conclusions

NS for left-sided colorectal cancer was a technically and oncologically feasible technique for selected patients.

Keywords

Colorectal cancer Minimally invasive surgery Needlescopic surgery Reduced port surgery 

Notes

Acknowledgments

The authors have no financial ties to disclose.

Conflict of interest

The authors declare that they have no conflict of interest.

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Copyright information

© Springer-Verlag Berlin Heidelberg 2014

Authors and Affiliations

  • Toshiki Mukai
    • 1
  • Yosuke Fukunaga
    • 1
  • Masashi Ueno
    • 1
  • Satoshi Nagayama
    • 1
  • Yoshiya Fujimoto
    • 1
  • Tsuyoshi Konishi
    • 1
  • Takashi Akiyoshi
    • 1
  • Riki Ono
    • 1
  • Toshiharu Yamaguchi
    • 1
  1. 1.Gastroenterological Center, Department of Gastroenterological Surgery, Cancer Institute HospitalJapanese Foundation for Cancer ResearchTokyoJapan

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