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.
Similar content being viewed by others
References
Pelosi MA, Pelosi MA III (1992) Laparoscopic supracervical hysterectomy using a single-umbilical puncture (minilaparoscopy). J Reprod Med 37:777–784
Pelosi MA, Pelosi MA III (1992) Laparoscopic appendectomy using a single umbilical puncture (minilaparoscopy). J Reprod Med 37:588–594
Bucher P, Pugin F, Morel P (2008) Single-port access laparoscopic right hemicolectomy. Int J Colorectal Dis 23:1013–1016
Rieger NA, Lam FF (2009) Single-incision laparoscopically assisted colectomy using standard laparoscopic instrumentation. Surg Endosc 24:888–890
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
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
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
Merchant AM, Lin E (2009) Single-incision laparoscopic right hemicolectomy for a colon mass. Dis Colon Rectum 52:1021–1024
Remzi FH, Kirat HT, Kaouk JH, Geisler DP (2008) Single-port laparoscopy in colorectal surgery. Colorectal Dis 10:823–826
Wexner SD, Cohen SM (1995) Port-site metastases after laparoscopic colorectal surgery for cure of malignancy. Br J Surg 82:295–298
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
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
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
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
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
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.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
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
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00464-010-1017-y