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Surgical Endoscopy

, Volume 26, Issue 3, pp 862–868 | Cite as

Single-incision laparoscopic total abdominal colectomy for refractory ulcerative colitis

  • Alessandro FicheraEmail author
  • Marco Zoccali
Dynamic Manuscript

Abstract

Background

A three-stage restorative proctocolectomy with ileal pouch-anal anastomosis is the treatment of choice for the particularly debilitated patient with medically refractory ulcerative colitis (UC). Laparoscopic surgery has been shown to offer several advantages over the open approach in this setting. Single-incision laparoscopic surgery is an emerging minimally invasive strategy representing a truly scarless procedure for the first surgical step, namely, the total abdominal colectomy (TAC).

Methods

Nine consecutive patients with medically refractory UC underwent a single-incision laparoscopic TAC between May and October 2010. All patients were on aggressive medical therapy with corticosteroids or immunosuppressors and were selected for this approach on the basis of their body habitus and the absence of relevant comorbidities. The whole operation was performed through a single access to the abdominal cavity, placed at the ostomy site marked preoperatively.

Results

Mean operating time was 142 ± 23 min, with an estimate blood loss of 108 ± 125 ml. No intraoperative complications or conversions to conventional laparoscopy or open surgery occurred. In all cases the postoperative course was uneventful. The return of bowel function was observed on postoperative day 1.7 ± 0.7, and patients could tolerate a solid diet on postoperative day 3 ± 0.5. The mean postoperative length of stay was 5.2 ± 1.3 days.

Conclusions

In our experience, a single-incision laparoscopic approach to total abdominal colectomy for refractory ulcerative colitis has been shown to be safe and feasible. Initial results suggest that this technique can lead to improvements in short-term outcomes in selected patients.

Keywords

Single-incision laparoscopic surgery Total abdominal colectomy Ulcerative colitis 

Notes

Disclosure

Dr. Alessando Fichera and Dr. Marco Zoccali have no conflicts of interest or financial ties to disclose.

Supplementary material

Supplementary material 1 (MPG 347233 kb)

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Copyright information

© Springer Science+Business Media, LLC 2011

Authors and Affiliations

  1. 1.Department of SurgeryUniversity of Chicago Medical CenterChicagoUSA
  2. 2.First General Surgery Unit, Department of SurgeryCatholic UniversityRomeItaly

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