Single port access laparoscopic right hemicolectomy

Abstract

Background

Single port access (SPA) surgery is a rapidly evolving field as it combines some of the cosmetic advantage of the Natural Orifice Translumenal Endoscopic Surgery (NOTES) and allows performing surgical procedure with standard surgical instruments. We report in this paper a new technique of umbilical SPA right hemicolectomy with conventional surgical oncologic principle and technique of minimally invasive colectomy.

Methods

Preliminary experience with umbilical SPA right hemicolectomy in a patient with degenerated ascending colon polyp.

Results

Umbilical SPA right hemicolectomy was feasible with conventional laparoscopic instruments. Carcinologic surgical principle can be respected using this technique as pathological specimen had sufficient surgical margins (>10 cm) and lymph nodes (33). Operative time was 158 min. No peroperative or postoperative complications were recorded.

Conclusion

SPA right hemicolectomy is feasible and safe when performed by experienced laparoscopic surgeons. SPA right hemicolectomy may have the advantage over NOTES approach to offer the safety of laparoscopic colectomy especially for haemostasis and anastomosis. It has to be determined whether or not this approach would offer benefit to patients, except in cosmesis, compared to standard laparoscopic right hemicolectomy.

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Fig. 1

References

  1. 1.

    Liang J, Lai H, Lee P (2007) Laparoscopic medial-to-lateral approach for the curative resection of right-sided colon cancer. Ann Surg Oncol 14:1878–1879

    PubMed  Article  Google Scholar 

  2. 2.

    Kim J, Edwards E, Bowne W, Castro A, Moon V, Gadangi P, Ferzli G (2007) Medial-to-lateral laparoscopic colon resection: a view beyond the learning curve. Surg Endosc 21:1503–1507

    PubMed  Article  CAS  Google Scholar 

  3. 3.

    Braga M, Frasson M, Vignali A, Zuliani W, Di Carlo V (2007) Open right colectomy is still effective compared to laparoscopy: results of a randomized trial. Ann Surg 246:1010–1014

    PubMed  Google Scholar 

  4. 4.

    Tong D, Law W (2007) Laparoscopic versus open right colectomy for carcinoma of the colon. J Soc Laparoendosc Surg 11:76–80

    Google Scholar 

  5. 5.

    Bucher P, Wuthrich P, Pugin F, Gonzalez M, Gervaz P, Morel P (2008) Totally intracorporeal laparoscopic colorectal anastomosis using circular stapler. Surg Endosc 22:1278–1282

    Article  PubMed  Google Scholar 

  6. 6.

    Wilson J, Dogiparthi K, Hebblethwaite N, Clarke M (2007) Laparoscopic right hemicolectomy with posterior colpotomy for transvaginal specimen retrieval. Colorectal Dis 9:662

    PubMed  Article  CAS  Google Scholar 

  7. 7.

    Lacy A, Delgado S, Rojas O, Almenara R, Blasi A, Llach J (2008) MA-NOS radical sigmoidectomy: report of a transvaginal resection in the human. Surg Endosc 22:1717–1723

    PubMed  Article  Google Scholar 

  8. 8.

    Varadarajulu S, Tamhane A, Drelichman E (2008) Patient perception of natural orifice transluminal endoscopic surgery as a technique for cholecystectomy. Gastrointest Endosc 67:854–860

    PubMed  Article  Google Scholar 

  9. 9.

    Li W, Xiao J (2008) Investigation for acceptance of natural orifice Translumenal Endoscopic surgery by inpatients with digestive disease. Gastrointest Endosc 67:AB120

    Article  Google Scholar 

  10. 10.

    Kaouk J, Haber G, Goel R, Desai M, Aron M, Rackley R, Moore C, Gill I (2008) Single-port laparoscopic surgery in urology: initial experience. Urology 71:3–6

    PubMed  Article  Google Scholar 

  11. 11.

    Zhu J (2007) Scarless endoscopic surgery: NOTES or TUES. Surg Endosc 21:1898–1899

    PubMed  Article  Google Scholar 

  12. 12.

    Pearl J, Ponsky J (2007) Natural orifice translumenal endoscopic surgery: a critical review. J Gastrointest Surg Dec 5 Epud ahead of print

  13. 13.

    Whiteford M, Denk P, Swanstrom L (2007) Feasibility of radical sigmoid colectomy performed as natural orifice translumenal endoscopic surgery (NOTES) using transanal endoscopic microsurgery. Surg Endosc 21:1870–1874

    PubMed  Article  CAS  Google Scholar 

  14. 14.

    Bucher P, Pugin F, Morel P (2008) Minimally invasive necrosectomy for infected necrotizing pancreatitis. Pancreas 36:113–119

    PubMed  Article  Google Scholar 

  15. 15.

    Ponsky J, Cherullo E, Sawyer M, Hartke D (2008) Single access site laparoscopic radical nephrectomy: initial clinical experience. J Endourol 22:663–666

    PubMed  Article  Google Scholar 

  16. 16.

    Gettman M, Box G, Averch T, Cadeddu J, Cherullo E, Clayman R, Desai M, Frank I, Gill I, Gupta M, Haber G, Humphreys M, Kaouk J, Landman J, Lima E, Ponsky L (2008) Consensus statement on Natural Orifice Transluminal Endoscopic Surgery and Single-Incision Laparoscopic Surgery: heralding a new era in urology. Eur Urol 53:1117–1120

    PubMed  Article  Google Scholar 

  17. 17.

    Pomp A (2008) Notes on NOTES: the emperor is not wearing any clothes. Surg Endosc 22:283–284

    PubMed  Article  Google Scholar 

  18. 18.

    Kaouk J, Palmer J (2008) Single-port laparoscopic surgery: initial experience in children for varicelectomy. BJU 102:97–99

    Article  Google Scholar 

  19. 19.

    Desai M, Rao P, Aron M, Pascal-Haber G, Desai M, Mishra S, Kaouk J, Gill I (2008) Scarless single port transumbilical nephrectomy and pyeloplasty: first clinical report. BJU Int 101:83–88

    PubMed  Article  Google Scholar 

  20. 20.

    Ates O, Hakguber G, Olguner M, Akgur F (2007) Single-port laparoscopic appendectomy conducted intracorporeally with the aid of a transabdominal sling suture. J Pediatr Surg 42:1071–1074

    PubMed  Article  Google Scholar 

  21. 21.

    Swanstrom L, Zheng B (2008) Spatial orientation and Off-Axis challenges for NOTES. Gastrointest Endosc Clin N Am 18:315–324

    PubMed  Article  Google Scholar 

  22. 22.

    Mintz Y, Horgan S, Cullen J, Ramamoorthy S, Chock A, Savu M, Easter D, Talamini M (2007) NOTES: the hybrid technique. J Laparoendosc Adv Surg Tech A 17:402–406

    PubMed  Article  Google Scholar 

  23. 23.

    ASGE., SAGES (2006) ASGE/SAGES Working Group on Natural Orifice Translumenal Endoscopic Surgery White Paper 2005. Gastrointest Endosc 63:199–203

    Article  Google Scholar 

  24. 24.

    Pigazzi A, Hellan M, Ewing D, Paz B, Ballantyne G (2007) Laparoscopic medial-to-lateral dissection: how and why. J Gastrointest Surg 11:778–782

    PubMed  Article  Google Scholar 

  25. 25.

    Dunker M, Stiggelbout A, Van Hogezand R, Ringers J, Griffioen G, Bemelman W (1998) Cosmesis and body image after laparoscopic-assisted and open ileocolic resection for Crohn’s disease. Surg Endosc 12:1334–1340

    PubMed  Article  CAS  Google Scholar 

  26. 26.

    Cuesta M, Berends F, Veenhof A (2008) The “invisible cholecystectomy": a transumbilical laparoscopic operation without a scar. Surg Endosc 22:1211–1213

    Article  PubMed  Google Scholar 

  27. 27.

    Bhoyrul S, Payne J, Steffes B, Swanstrom L, Way L (2000) A randomized prospective study of radially expanding trocars in laparoscopic surgery. J Gastrointest Surg 4:392–397

    PubMed  Article  CAS  Google Scholar 

  28. 28.

    Loriau J, Manaouil D, Verhaeghe P (2002) Celioscopie: les éventration sur orifice de trocarts. Ann Chir 127:252–256

    PubMed  Article  CAS  Google Scholar 

  29. 29.

    Lewis J (1995) A simple technique for anticipating and managing secondary puncture site hemorrhage during laparoscopic surgery. A report of two cases. J Reprod Med 40:729–730

    PubMed  CAS  Google Scholar 

  30. 30.

    Rane A, Rao P, Rao P (2008) Single-Port-Access Nephrectomy and other laparoscopic urologic procedure using a novel laparoscopic port (R-Port). Urology May 9 Epud ahead of print

  31. 31.

    Buess G, Cuschieri A (2007) Raising our heads above the parapet: ES not NOTES. Surg Endosc 21:835–837

    PubMed  Article  CAS  Google Scholar 

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Correspondence to Pascal Bucher.

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Bucher, P., Pugin, F. & Morel, P. Single port access laparoscopic right hemicolectomy. Int J Colorectal Dis 23, 1013 (2008). https://doi.org/10.1007/s00384-008-0519-8

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Keywords

  • Single port access (SPA)
  • Colectomy
  • Laparoscopy
  • NOTES
  • Minimally invasive surgery
  • Technique
  • Scarless surgery