Surgical Endoscopy

, Volume 27, Issue 2, pp 471–477 | Cite as

Conventional laparoscopic versus single-incision laparoscopic right hemicolectomy: a case cohort comparison of short-term outcomes in 144 consecutive cases

  • Min-Hoe Chew
  • Mei-Huan Chang
  • Wah-Siew Tan
  • Mark Te-Ching Wong
  • Choong-Leong TangEmail author



Single-incision laparoscopic surgery (SILS) is a recent development of minimally invasive surgery for colorectal disease. The literature comparing it against conventional laparoscopic colectomy remains limited.


A retrospective case–cohort study compared the benefits and outcomes of SILS right hemicolectomy (SRH) with those of conventional laparoscopic right hemicolectomy (LRH). The medical records of consecutive patients from a prospectively collected database were reviewed. Demographic data, operative details, recovery parameters, and details of resected specimens were obtained and analyzed in an intention-to-treat manner.


From January 2006 to March 2011, 104 elective LRHs (72 %) and 40 elective SRHs (28 %) were performed. The demographics for these two groups were comparable in terms of gender, age, ethnicity, body mass index (BMI), comorbidities and American Society of Anesthesiology score. As the records showed, 62 % of the LRHs and 57 % of the SRHs were performed for malignancies (p = 0.536). Seven of the LRH cases (7 %) were converted to open procedure, whereas two of the SILS cases (5 %) were converted. Three SILS cases (7 %) were completed with additional laparoscopic ports. The two groups did not differ significantly in terms of wound length, mean operative time, lymph node clearance, or margins of resected specimen. The recovery parameters (pain score, hospital length of stay, and complications rate) also were equivalent between the two groups.


As a feasible and safe procedure with early postoperative outcomes equivalent to those for LRH, SRH is a suitable alternative. The possible advantages of SILS over conventional laparoscopic surgery may be validated only with randomized controlled trials in the future.


Right hemicolectomy Safety Single-incision laparoscopic colectomy 



Min-Hoe Chew, Mei-huan Chang, Wah-Siew Tan, Mark Te-Ching Wong, and Choong-Leong Tang have no conflicts of interest or financial ties to disclose.


  1. 1.
    Bucher P, Pugin F, Morel P (2008) Single-port access laparoscopic right hemicolectomy. Int J Colorectal Dis 23:1013–1016PubMedCrossRefGoogle Scholar
  2. 2.
    Remzi FH, Kirat HT, Kaouk JH, Geisler DP (2008) Single-port laparoscopy in colorectal surgery. Colorectal Dis 10:823–826PubMedCrossRefGoogle Scholar
  3. 3.
    Law WL, Fan JK, Poon JT (2010) Single-incision laparoscopic colectomy: early experience. Dis Colon Rectum 53:284–288PubMedCrossRefGoogle Scholar
  4. 4.
    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 144:173–179PubMedCrossRefGoogle Scholar
  5. 5.
    Romanelli JR, Earle DB (2009) Single-port laparoscopic surgery: an overview. Surg Endosc 23:1419–1427PubMedCrossRefGoogle Scholar
  6. 6.
    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 24:2613–2616PubMedCrossRefGoogle Scholar
  7. 7.
    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 24:3233–3236PubMedCrossRefGoogle Scholar
  8. 8.
    Chow AG, Purkayastha S, Zacharakis E, Paraskeva P (2011) Single-incision laparoscopic surgery for right hemicolectomy. Arch Surg 146:183–186PubMedCrossRefGoogle Scholar
  9. 9.
    Saber AA, El-Ghazaly TH (2011) Single-incision transumbilical laparoscopic right hemicolectomy using SILS port. Am Surg 77:252–253PubMedGoogle Scholar
  10. 10.
    Chambers WM, Bicsak M, Lamparelli M, Dixon AR (2011) Single-incision laparoscopic surgery (SILS) in complex colorectal surgery: a technique offering potential and not just cosmesis. Colorectal Dis 13:393–398PubMedCrossRefGoogle Scholar
  11. 11.
    Keshava A, Young CJ, Mackenzie S (2010) Single-incision laparoscopic right hemicolectomy. Br J Surg 97:1881–1883PubMedCrossRefGoogle Scholar
  12. 12.
    Chow AG, Purkayastha S, Zacharakis E, Paraskeva P (2011) Single-incision laparoscopic surgery for right hemicolectomy. Arch Surg 146:183–186PubMedCrossRefGoogle Scholar
  13. 13.
    Advani V, Ahad S, Hassan I (2011) Single-incision laparoscopic right hemicolectomy for colon cancer: less is more? Surg Innov 18:NP4–NP6PubMedCrossRefGoogle Scholar
  14. 14.
    Edge SB, Byrd DR, Compton CC, Fritz AG, Greene FL, Trotti A (2009) AJCC cancer staging manual, 7th edn. Springer, New YorkGoogle Scholar
  15. 15.
    Wong MT, Ng KH, Ho KS, Eu KW (2010) Single-incision laparoscopic surgery for right hemicolectomy: our initial experience with 10 cases. Tech Coloproctol 14:225–228PubMedCrossRefGoogle Scholar
  16. 16.
    Chew MH, Wong MT, Lim BY, Ng KH, Eu KW (2011) Evaluation of current devices in single-incision laparoscopic colorectal surgery: a preliminary experience in 32 consecutive cases. World J Surg 35:873–880PubMedCrossRefGoogle Scholar
  17. 17.
    Lim YK, Ng KH, Eu KW (2010) Single-site laparoscopic right hemicolectomy: an oncological feasible option. World J Surg Oncol 8:79PubMedCrossRefGoogle Scholar
  18. 18.
    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 53:1549–1554PubMedCrossRefGoogle Scholar
  19. 19.
    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 25:1887–1892PubMedCrossRefGoogle Scholar
  20. 20.
    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 53:1467–1472PubMedCrossRefGoogle Scholar
  21. 21.
    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 213:72–80PubMedCrossRefGoogle Scholar
  22. 22.
    Reichenbach DJ, Tackett AD, Harris J, Camacho D, Graviss EA, Dewan B, Vavra A, Stiles A, Fisher WE, Brunicardi FC, Sweeney JF (2006) Laparoscopic colon resection early in the learning curve: what is the appropriate setting. Ann Surg 243:730–737PubMedCrossRefGoogle Scholar
  23. 23.
    Waters JA, Chihara R, George VV (2010) Laparoscopic colectomy: does the learning curve extend beyond colorectal surgery fellowship? JSLS 14:325–331PubMedCrossRefGoogle Scholar
  24. 24.
    Maeda T, Tan KY, Konishi F, Tsujinaka S, Mizokami K, Sasaki J, Kawamura YJ (2010) Accelerated learning curve for colorectal resection, open versus laparoscopic approach, can be attained with expert supervision. Surg Endosc 24:2850–2854PubMedCrossRefGoogle Scholar
  25. 25.
    Tan WS, Chew MH, Ooi BS, Ng KH, Lim JF, Ho KS, Tang CL, Eu KW (2009) Laparoscopic versus open right hemicolectomy: a comparison of short-term outcomes. Int J Colorectal Dis 24:1333–1339PubMedCrossRefGoogle Scholar
  26. 26.
    Marusch F, Gastinger I, Schneider C, Scheidbach H, Konradt J, Bruch HP, Köhler L, Bärlehner E, Köckerling F, Laparoscopic Colorectal Surgery Study Group (LCSSG) (2001) Importance of conversion for results obtained with laparoscopic colorectal surgery. Dis Colon Rectum 44:207–216PubMedCrossRefGoogle Scholar
  27. 27.
    Christen D, Buchmann P (1996) Sources of hazards in laparoscopic colon surgery and how to avoid them. Swiss Surg 2:203–207PubMedGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2012

Authors and Affiliations

  • Min-Hoe Chew
    • 1
  • Mei-Huan Chang
    • 1
  • Wah-Siew Tan
    • 1
  • Mark Te-Ching Wong
    • 1
  • Choong-Leong Tang
    • 1
    Email author
  1. 1.Department of Colorectal SurgerySingapore General HospitalSingaporeSingapore

Personalised recommendations