Single-incision laparoscopic colectomy without using special articulating instruments: an initial experience
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RESEARCH
WORLD JOURNAL OF SURGICAL ONCOLOGY
Open Access
Single-incision laparoscopic colectomy without using special articulating instruments: an initial experience Atthaphorn Trakarnsanga, Thawatchai Akaraviputh*, Pakpong Wathanaoran, Chainarong Phalanusitthepha, Asada Methasate and Vitoon Chinswangwattanakul
Abstract Background: Single-incision laparoscopic colectomy (SILC) was introduced as a novel minimally invasive technique. The benefits of this technique include reducing number of the incision and cosmetic improvement. Unlike the conventional laparoscopic colectomy, majority of previously reported SILC need to be performed using special curved or articulated instruments. The purpose of this study is to demonstrate our initial experience of SILC, which could be performed using the standard laparoscopic instruments. Material and methods: Retrospective review of 14 patients who underwent SILC at Siriraj Hospital from May to December 2010, patient’s demographic data, perioperative outcomes, early postoperative complications and pathological data were collected and analyzed. Results: The mean age of all patients was 60 years. The most common operation with SILC was sigmoidectomy (n = 9), followed by right hemicolectomy (n = 2), left hemicolectomy (n = 1), anterior resection (n = 1), and total colectomy (n = 1). The trocar insertion techniques were multi-fascial incision using regular port (n = 11) and GelPOINT® (n = 3). The mean operative time was 155 minutes (range 90-280) and the mean estimate blood loss was 32.1 mL (range 10-100). All patients were successfully operated without conversion. The mean length of hospital stay was 9 days (range 5-20). There was no mortality. The pathological results revealed colorectal cancer (n = 12), neoplastic polyp (n = 1) and Familial adenomatous polyposis (FAP) (n = 1). The mean number of lymph nodes retrieval was 16.6 (range 3-34). Conclusion: SILC can successfully and safely be performed with standard laparoscopic instruments. This technique might be an alternative procedure to conventional laparoscopic colectomy with better cosmetic result. Keywords: Minimally invasive surgery, Single-incision laparoscopic colectomy, Laparoscopic colectomy, Colorectal neoplasms
Background Recently, minimally invasive surgery for colon cancer treatment became more popular. This approach provided better short-term advantages, such as less postoperative pain, rapid return of bowel function, shorter hospitalization and rapidly returns to normal activity, compare to conventional open method. However, there are no differences in terms of post-operative complications and * Correspondence: [email protected] Minimally Invasive Surgery Unit, Division of General Surgery, Department of Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand
mortality rate compare to conventional open method [1-4]. Moreover, the long-term oncological outcome is not significantly different between both methods [5-8]. In 1992, Pelosi et al. [9] firstly reported the successful te
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