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Single-port laparoscopic total proctocolectomy with ileal pouch-anal anastomosis: initial operative experience

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Abstract

Background

Single-port laparoscopic surgery (SPLS) has been used in urologic, gynecologic, general, and colorectal surgery. We herein report our experience with the use of SPLS for total proctocolectomy with ileal pouch-anal anastomosis (RP/IPAA).

Methods

All patients who underwent a RP/IPAA using SPLS between June and September 2009 were identified from a prospectively maintained laparoscopic database. All procedures were performed with the use of a 5-mm Olympus EndoEye™ and traditional laparoscopic instruments via a SILS™ port placed at the planned ileostomy site.

Results

There were five patients (3 male) included in the study. Median age was 43 years (range = 13–47 years). Median body mass index was 20.66 kg/m2 (range = 14.63–25.97 kg/m2). Diagnoses included ulcerative colitis (n = 4) and familial adenomatous polyposis (n = 1). Median ASA score was 2 (range = 1–3). Median operative time was 153 min (range = 132–278 min). Median estimated blood loss was 100 ml (range = 50–200 ml). There were no conversions to either a conventional laparoscopic or an open procedure. Median time to return of bowel function was 2 days. Median length of stay was 4 days (range = 3–6 days). Postoperative complications included two patients with partial small-bowel obstructions. Both resolved with conservative management. All patients had their ileostomies closed.

Conclusion

RP/IPAA using SPLS is a safe technique. Additional studies are needed to compare SPLS to conventional laparoscopy and open surgery with respect to operative times, convalescence, and outcomes.

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Disclosures

Dr. Daniel P. Geisler is a consultant to Covidien Corporation. Drs. Hasan T. Kirat and Feza H. Remzi have no conflicts of interest or financial ties to disclose.

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Authors and Affiliations

  1. Department of Colorectal Surgery, Cleveland Clinic Foundation, 9500 Euclid Avenue, A30, Cleveland, OH, 44195, USA

    Daniel P. Geisler, Hasan T. Kirat & Feza H. Remzi

Authors
  1. Daniel P. Geisler
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  2. Hasan T. Kirat
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  3. Feza H. Remzi
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Corresponding author

Correspondence to Feza H. Remzi.

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Geisler, D.P., Kirat, H.T. & Remzi, F.H. Single-port laparoscopic total proctocolectomy with ileal pouch-anal anastomosis: initial operative experience. Surg Endosc 25, 2175–2178 (2011). https://doi.org/10.1007/s00464-010-1518-8

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  • DOI: https://doi.org/10.1007/s00464-010-1518-8

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