Skip to main content

Advertisement

Log in

Evaluation of Current Devices in Single-Incision Laparoscopic Colorectal Surgery: A Preliminary Experience in 32 Consecutive Cases

  • Published:
World Journal of Surgery Aims and scope Submit manuscript

Abstract

Background

Single-incision laparoscopic colorectal surgery (SILS) suggests a promising alternative to conventional laparoscopic surgery. In this report we describe our initial experience with SILS for both right hemicolectomies and anterior resections.

Methods

Between June 2009 and May 2010, SILS was performed for 32 consecutive cases with benign and malignant pathology. Demographic data, intraoperative parameters, postoperative data, and pathologic data were assessed.

Results

Twenty-one SILS right hemicolectomies, ten ARs, and one abdominal perineal resection (APR) were performed. For SILS right hemicolectomies, one case required full “conversion” to a laparoscopic procedure. The median operating time was 85 min (range 45–150 min) and the median wound length was 5.0 cm (range 3.0–10.0 cm). Median number of lymph nodes extracted in malignant cases was 17(range 10–30) and the overall median length of stay was 6 days (range 5–11). For left-sided lesions, ten cases of ARs (7 high ARs, 2 low ARs, 1 ultralow AR) and one APR were performed. Three cases were completed successfully via the SILS procedure, four cases required one additional port, and four cases required full “conversion” to a laparoscopic procedure. The median operating time was 120 min (range 65–235 min) and the median wound length was 5.0 cm (range 3.0–7.0 cm). Overall median length of stay was also 6 days (range 5–21). There was one case of anastomotic leak and one case of postoperative bleeding.

Conclusion

In our experience, SILS for right hemicolectomies is safe and effective with reproducible oncologic results. SILS AR, however, requires greater modifications in current devices and techniques. SILS AR can be performed for both malignant and benign diseases but additional ports may be necessary for the safe completion of the procedure.

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

Access this article

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

Instant access to the full article PDF.

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5

Similar content being viewed by others

References

  1. Lacy AM, Garcia-Valdecasas JC, Delgado S et al (2002) Laparoscopy-assisted colectomy versus open colectomy for treatment of non-metastatic colon cancer: a randomised trial. Lancet 359:2224–2229

    Article  PubMed  Google Scholar 

  2. The Clinical Outcomes of Surgical Therapy Study Group (2004) A comparison of laparoscopically assisted and open colectomy for colon cancer. N Engl J Med 350(20):2050–2059

    Article  Google Scholar 

  3. Jayne DG, Guillou PJ, Thorpe H, UK MRC CLASICC Trial Group (2007) Randomized trial of laparoscopic-assisted resection of colorectal carcinoma: 3-year results of the UK MRC CLASICC Trial Group. J Clin Oncol 25(21):3061–3068

    Article  PubMed  Google Scholar 

  4. Buunen M, Veldkamp R, Hop WC, Colon Cancer Laparoscopic or Open Resection Study Group et al (2009) Survival after laparoscopic surgery versus open surgery for colon cancer: long-term outcome of a randomised clinical trial. Lancet Oncol 10(1):44–52

    Article  PubMed  Google Scholar 

  5. Abraham NS, Young JM, Solomon MJ (2004) Meta-analysis of short-term outcomes after laparoscopic resection for colorectal cancer. Br J Surg 91:1111–1124

    Article  PubMed  CAS  Google Scholar 

  6. Kuhry E, Schwenk WF, Gaupset R et al (2008) Long-term results of laparoscopic colorectal cancer resection. Cochrane Database Syst Rev 16(2):CD003432

    Google Scholar 

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

    Article  PubMed  Google Scholar 

  8. Remzi FH, Kirat HT, JH Kaouk et al (2008) Single port laparoscopy in colorectal surgery. Colorectal Dis 10:823–826

    Article  PubMed  CAS  Google Scholar 

  9. Leroy J, Cahill RA, M Asakuma et al (2009) Single-access laparoscopic sigmoidectomy as definitive surgical management of prior diverticulitis in a human patient. Arch Surg 144:173–179

    Article  PubMed  Google Scholar 

  10. Ramos-Valadez DI, Patel CB, Ragupathi M et al (2010) Single-incision laparoscopic right hemicolectomy: safety and feasibility in a series of consecutive cases. Surg Endosc 24(10):2613–2616

    Article  PubMed  Google Scholar 

  11. Boni L, Dionigi G, E Cassinotti et al (2010) Single incision laparoscopic right colectomy. Surg Endosc 24(12):3233–3236

    Article  PubMed  Google Scholar 

  12. Vestweber B, Alfes A, Paul C et al (2010) Single-incision laparoscopic surgery: a promising approach to sigmoidectomy for diverticular disease. Surg Endosc 24(12):3225–3228

    Article  PubMed  Google Scholar 

  13. Chambers W, Bicsak M, Lamparelli M et al (2011) Single incision laparoscopic surgery (SILS) in complex colorectal surgery: a technique offering potential and not just cosmesis. Colorectal Dis (Epub)

  14. Law WL, Fan JK, Poon JT (2010) Single-incision laparoscopic colectomy: early experience. Dis Colon Rectum 53(3):284–288

    PubMed  Google Scholar 

  15. Merchant AM, Cook MW, BC White et al (2009) Transumbilical Gelport access technique for performing single-incision laparoscopic surgery (SILS). J Gastrointest Surg 13(1):159–162

    Article  PubMed  Google Scholar 

  16. Rieger NA, Lam FF (2010) Single-incision laparoscopically assisted colectomy using standard laparoscopic instrumentation. Surg Endosc 24(4):888–890

    Article  PubMed  Google Scholar 

  17. Navarra G, Pozza E, Occhionorelli S et al (1997) One-wound laparoscopic cholecystectomy. Br J Surg 84:695

    Article  PubMed  CAS  Google Scholar 

  18. Eposito C (1998) One-trocar appendectomy in pediatric surgery. Surg Endosc 12:177–178

    Article  Google Scholar 

  19. Romanelli JR, Earle DB (2009) Single-port laparoscopic surgery: an overview. Surg Endosc 23(7):1419–1427

    Article  PubMed  Google Scholar 

  20. Tan WS, Chew MH, Ooi BS et al (2009) Laparoscopic versus open right hemicolectomy: a comparison of short-term outcomes. Int J Colorectal Dis 24(11):1333–1339

    Article  PubMed  Google Scholar 

  21. Wong MT, Ng KH, Ho KS et al (2010) Single-incision laparoscopic surgery for right hemicolectomy: our initial experience with 10 cases. Tech Coloproctol 14(3):225–228

    Article  PubMed  CAS  Google Scholar 

  22. Chew MH, Ng KH, Fook-Chong MC et al (2011) Redefining conversion in laparoscopic colectomy and its influence on outcomes: analysis of 418 cases from a single institution. World J Surg 35(1):178–185

    Article  PubMed  Google Scholar 

Download references

Acknowledgments

The authors thank Dr. Hak-Mien Quah, Dr. Poh-Koon Koh, Dr. Jit-Fong Lim, Dr. Kok-Sun Ho, and A/Prof Choong-Leong Tang for their contributions.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Kong-Weng Eu.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Chew, MH., Wong, M.TC., Lim, B.YK. et al. Evaluation of Current Devices in Single-Incision Laparoscopic Colorectal Surgery: A Preliminary Experience in 32 Consecutive Cases. World J Surg 35, 873–880 (2011). https://doi.org/10.1007/s00268-011-0989-7

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00268-011-0989-7

Keywords

Navigation