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Single-incision laparoscopic right hemicolectomy: safety and feasibility in a series of consecutive cases

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Abstract

Background

Single-incision laparoscopic colectomy (SILC) is rapidly emerging in the field of minimally invasive colon and rectal surgery. This report presents the safety and feasibility of performing SILC right hemicolectomy with the SILS™ Port Multiple Instrument Access Port.

Methods

Between July 2009 and October 2009, SILC right hemicolectomy was performed for 13 consecutive, unselected patients presenting with benign or malignant pathology. Demographic data, intraoperative parameters, and postoperative outcomes were assessed.

Results

For 11 of the 13 patients (84.6%), the SILC procedure was performed with a mean incision length of 3.1 ± 1.1 cm (range, 2.5–6.0 cm) and a mean operative time of 131.5 ± 36.2 min (range, 79–180 min). Two cases required conversion to hand-assisted technique. Overall, the operative time was found to be significantly longer for the patients with a body mass index (BMI) greater than 25 kg/m2 (152.1 ± 26.6 min) compared with the patients with a BMI less than 25 kg/m2 (93.3 ± 11.6 min) (p < 0.002). For the subset of patients with malignant disease (five adenocarcinomas and one carcinoid), the mean number of lymph nodes extracted was 26.7 ± 14.5. There were no intraoperative complications, and the overall mean hospital stay was 2.5 ± 0.7 days (range, 2–4 days). One postoperative complication occurred (7.7%).

Conclusion

The SILC procedure is a safe and feasible method for benign and malignant diseases requiring a right hemicolectomy. This method results in a low complication rate and a short postoperative hospital stay.

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References

  1. Pelosi MA, Pelosi MA III (1992) Laparoscopic supracervical hysterectomy using a single-umbilical puncture (minilaparoscopy). J Reprod Med 37:777–784

    CAS  PubMed  Google Scholar 

  2. Pelosi MA, Pelosi MA III (1992) Laparoscopic appendectomy using a single umbilical puncture (minilaparoscopy). J Reprod Med 37:588–594

    CAS  PubMed  Google Scholar 

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

    Article  PubMed  Google Scholar 

  4. Rieger NA, Lam FF (2009) Single-incision laparoscopically assisted colectomy using standard laparoscopic instrumentation. Surg Endosc 24:888–890

    Article  PubMed  Google Scholar 

  5. Patel CB, Ramos-Valadez DI, Ragupathi M, Haas EM (2010) Single incision laparoscopic-assisted right hemicolectomy technique: application for a mass of the ascending colon (with video). Surg Laparosc Endosc Percutan Tech

  6. Brunner W, Schirnhofer J, Waldstein-Wartenberg N, Frass R, Weiss H (2009) Single-incision laparoscopic sigmoid colon resections without visible scar: a novel technique. Colorectal Dis 12:66–70

    Article  Google Scholar 

  7. 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 144:173–179 discussion 179

    Article  PubMed  Google Scholar 

  8. Merchant AM, Lin E (2009) Single-incision laparoscopic right hemicolectomy for a colon mass. Dis Colon Rectum 52:1021–1024

    PubMed  Google Scholar 

  9. Remzi FH, Kirat HT, Kaouk JH, Geisler DP (2008) Single-port laparoscopy in colorectal surgery. Colorectal Dis 10:823–826

    Article  CAS  PubMed  Google Scholar 

  10. Wexner SD, Cohen SM (1995) Port-site metastases after laparoscopic colorectal surgery for cure of malignancy. Br J Surg 82:295–298

    Article  CAS  PubMed  Google Scholar 

  11. Ziprin P, Ridgway PF, Peck DH, Darzi AW (2002) The theories and realities of port-site metastases: a critical appraisal. J Am Coll Surg 195:395–408

    Article  PubMed  Google Scholar 

  12. Sooriakumaran P, Kommu SS, Anderson C, Rane A (2009) Port-site metastasis after laparoscopic surgery: what causes them and what can be done to reduce their incidence? BJU Int 103:1150–1153

    Article  PubMed  Google Scholar 

  13. Veldkamp R, Kuhry E, Hop WC, Jeekel J, Kazemier G, Bonjer HJ, Haglind E, Påhlman L, Cuesta MA, Msika S, Morino M, Lacy AM, Colon Cancer Laparoscopic or Open Resection Study Group (2005) Laparoscopic surgery versus open surgery for colon cancer: short-term outcomes of a randomised trial. Lancet Oncol 6:477–484

    Article  PubMed  Google Scholar 

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

    Article  Google Scholar 

  15. Guillou PJ, Quirke P, Thorpe H, Walker J, Jayne DG, Smith AM, Heath RM, Brown JM, MRC CLASICC trial group (2005) Short-term endpoints of conventional versus laparoscopic-assisted surgery in patients with colorectal cancer (MRC CLASICC trial): multicentre, randomised controlled trial. Lancet 365:1718–1726

    Article  PubMed  Google Scholar 

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Disclosures

Diego I. Ramos-Valadez, Chirag B. Patel, Madhu Ragupathi, T. Bartley Pickron, and Eric M. Haas have no conflicts of interest or financial ties to disclose.

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Correspondence to Eric M. Haas.

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Ramos-Valadez, D.I., Patel, C.B., Ragupathi, M. et al. Single-incision laparoscopic right hemicolectomy: safety and feasibility in a series of consecutive cases. Surg Endosc 24, 2613–2616 (2010). https://doi.org/10.1007/s00464-010-1017-y

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  • DOI: https://doi.org/10.1007/s00464-010-1017-y

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