Skip to main content
Top
Published in: Surgical Endoscopy 10/2010

01-10-2010

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

Authors: Diego I. Ramos-Valadez, Chirag B. Patel, Madhu Ragupathi, T. Bartley Pickron, Eric M. Haas

Published in: Surgical Endoscopy | Issue 10/2010

Login to get access

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.
Literature
1.
go back to reference Pelosi MA, Pelosi MA III (1992) Laparoscopic supracervical hysterectomy using a single-umbilical puncture (minilaparoscopy). J Reprod Med 37:777–784PubMed Pelosi MA, Pelosi MA III (1992) Laparoscopic supracervical hysterectomy using a single-umbilical puncture (minilaparoscopy). J Reprod Med 37:777–784PubMed
2.
go back to reference Pelosi MA, Pelosi MA III (1992) Laparoscopic appendectomy using a single umbilical puncture (minilaparoscopy). J Reprod Med 37:588–594PubMed Pelosi MA, Pelosi MA III (1992) Laparoscopic appendectomy using a single umbilical puncture (minilaparoscopy). J Reprod Med 37:588–594PubMed
3.
go back to reference Bucher P, Pugin F, Morel P (2008) Single-port access laparoscopic right hemicolectomy. Int J Colorectal Dis 23:1013–1016CrossRefPubMed Bucher P, Pugin F, Morel P (2008) Single-port access laparoscopic right hemicolectomy. Int J Colorectal Dis 23:1013–1016CrossRefPubMed
4.
go back to reference Rieger NA, Lam FF (2009) Single-incision laparoscopically assisted colectomy using standard laparoscopic instrumentation. Surg Endosc 24:888–890CrossRefPubMed Rieger NA, Lam FF (2009) Single-incision laparoscopically assisted colectomy using standard laparoscopic instrumentation. Surg Endosc 24:888–890CrossRefPubMed
5.
go back to reference 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 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.
go back to reference 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 12:66–70CrossRef 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 12:66–70CrossRef
7.
go back to reference 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 179CrossRefPubMed 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 179CrossRefPubMed
8.
go back to reference Merchant AM, Lin E (2009) Single-incision laparoscopic right hemicolectomy for a colon mass. Dis Colon Rectum 52:1021–1024PubMed Merchant AM, Lin E (2009) Single-incision laparoscopic right hemicolectomy for a colon mass. Dis Colon Rectum 52:1021–1024PubMed
9.
go back to reference Remzi FH, Kirat HT, Kaouk JH, Geisler DP (2008) Single-port laparoscopy in colorectal surgery. Colorectal Dis 10:823–826CrossRefPubMed Remzi FH, Kirat HT, Kaouk JH, Geisler DP (2008) Single-port laparoscopy in colorectal surgery. Colorectal Dis 10:823–826CrossRefPubMed
10.
go back to reference Wexner SD, Cohen SM (1995) Port-site metastases after laparoscopic colorectal surgery for cure of malignancy. Br J Surg 82:295–298CrossRefPubMed Wexner SD, Cohen SM (1995) Port-site metastases after laparoscopic colorectal surgery for cure of malignancy. Br J Surg 82:295–298CrossRefPubMed
11.
go back to reference Ziprin P, Ridgway PF, Peck DH, Darzi AW (2002) The theories and realities of port-site metastases: a critical appraisal. J Am Coll Surg 195:395–408CrossRefPubMed Ziprin P, Ridgway PF, Peck DH, Darzi AW (2002) The theories and realities of port-site metastases: a critical appraisal. J Am Coll Surg 195:395–408CrossRefPubMed
12.
go back to reference 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 103:1150–1153CrossRefPubMed 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 103:1150–1153CrossRefPubMed
13.
go back to reference 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 6:477–484CrossRefPubMed 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 6:477–484CrossRefPubMed
14.
go back to reference Clinical Outcomes of Surgical Therapy Study Group (2004) A comparison of laparoscopically assisted and open colectomy for colon cancer. N Engl J Med 350:2050–2059CrossRef Clinical Outcomes of Surgical Therapy Study Group (2004) A comparison of laparoscopically assisted and open colectomy for colon cancer. N Engl J Med 350:2050–2059CrossRef
15.
go back to reference 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 365:1718–1726CrossRefPubMed 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 365:1718–1726CrossRefPubMed
Metadata
Title
Single-incision laparoscopic right hemicolectomy: safety and feasibility in a series of consecutive cases
Authors
Diego I. Ramos-Valadez
Chirag B. Patel
Madhu Ragupathi
T. Bartley Pickron
Eric M. Haas
Publication date
01-10-2010
Publisher
Springer-Verlag
Published in
Surgical Endoscopy / Issue 10/2010
Print ISSN: 0930-2794
Electronic ISSN: 1432-2218
DOI
https://doi.org/10.1007/s00464-010-1017-y

Other articles of this Issue 10/2010

Surgical Endoscopy 10/2010 Go to the issue