Skip to main content
Top
Published in: Surgical Endoscopy 12/2010

01-12-2010 | New Technology

Single-incision laparoscopic surgery: a promising approach to sigmoidectomy for diverticular disease

Authors: Boris Vestweber, Angelika Alfes, Claudia Paul, Franz Haaf, Karl-Heinz Vestweber

Published in: Surgical Endoscopy | Issue 12/2010

Login to get access

Abstract

Background

Laparoscopic sigmoidectomy has become the standard procedure in elective surgery for recurrent diverticular disease. To realize further benefits of this minimal invasive procedure and to offer less postoperative pain, shorter recovery time, reduced complications, and improved cosmetic results, attempts are being made to minimize the number of necessary skin incisions for trocar positioning. One method is to use only one port for laparoscopic access to perform diverticular-related elective sigmoidectomies.

Methods

Between 7 July and 4 August 2009, 10 consecutive patients were referred for partial left colon resection due to multiple episodes of diverticulitis. In all cases, access to the abdomen was achieved through a 2- to 2.5-cm single incision via the umbilicus followed by insertion of the single-incision laparoscopic surgery (SILS™) port system. Outcomes such as change in the procedural method, operative time, postoperative complications, and length of stay were recorded.

Results

Of the 10 consecutive sigmoidectomies, 9 were performed successfully with the SILS™ procedure using only one incision in the umbilicus. No mortalities or major complications were noted. The median operating time was 120 min, and the median postoperative hospital stay was 7 days.

Conclusion

As an alternative to the standard laparoscopic procedure, single-incision laparoscopic sigmoidectomy via the umbilicus is technically feasible and effective. This attractive procedure aims to increase the patient’s comfort further after abdominal surgery.
Literature
1.
go back to reference Marohn MR, Hanly EJ, Mc Kenna KJ, Varin CR (2005) Laparoscopic total abdominal colectomy in the acute setting. J Gastrointest Surg 9:881–886CrossRefPubMed Marohn MR, Hanly EJ, Mc Kenna KJ, Varin CR (2005) Laparoscopic total abdominal colectomy in the acute setting. J Gastrointest Surg 9:881–886CrossRefPubMed
2.
go back to reference Rosman AS, Melis M, Fichera A (2005) Metaanalysis of trials comparing laparoscopic and open surgery for Crohn’s disease. Surg Endosc 19:1549–1555CrossRefPubMed Rosman AS, Melis M, Fichera A (2005) Metaanalysis of trials comparing laparoscopic and open surgery for Crohn’s disease. Surg Endosc 19:1549–1555CrossRefPubMed
3.
go back to reference Tacchino R, Greco F, Matera D (2009) Single-incision laparoscopic cholecystectomy: surgery without a visible scar. Surg Endosc 23:896–899CrossRefPubMed Tacchino R, Greco F, Matera D (2009) Single-incision laparoscopic cholecystectomy: surgery without a visible scar. Surg Endosc 23:896–899CrossRefPubMed
5.
go back to reference Nguyen NT, Reavis KM, Hinojosa MW, Smith BR, Stamos MJ (2009) A single-port technique for laparoscopic extended stapled appendectomy. Surg Innov 16:78–81CrossRefPubMed Nguyen NT, Reavis KM, Hinojosa MW, Smith BR, Stamos MJ (2009) A single-port technique for laparoscopic extended stapled appendectomy. Surg Innov 16:78–81CrossRefPubMed
7.
go back to reference Gonzales JJ (2009) Sleeve gastrectomy and the SILS™ procedure: The Texas Endosurgery Institute Experience. Bariatric Times 6((Suppl2)):6–7 Gonzales JJ (2009) Sleeve gastrectomy and the SILS™ procedure: The Texas Endosurgery Institute Experience. Bariatric Times 6((Suppl2)):6–7
8.
go back to reference Remzi FH, Kirat HAT, Kaouk JH, Geisler DP (2008) Single-port laparoscopy in colorectal surgery. Colorectal Dis 10:823–826CrossRefPubMed Remzi FH, Kirat HAT, Kaouk JH, Geisler DP (2008) Single-port laparoscopy in colorectal surgery. Colorectal Dis 10:823–826CrossRefPubMed
9.
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
10.
go back to reference Leroy J, Cahill RA, Peretta S, Marescaux J (2008) Single-port sigmoidectomy in an experimental model with survival. Surg Innov 15:260–265CrossRefPubMed Leroy J, Cahill RA, Peretta S, Marescaux J (2008) Single-port sigmoidectomy in an experimental model with survival. Surg Innov 15:260–265CrossRefPubMed
11.
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 144:173–179CrossRefPubMed 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 144:173–179CrossRefPubMed
12.
go back to reference Brunner W, Schirnhofer J, Waldstein-Wartenberg N, Frass R, Pimpl K, Weiss H (2009) New: single-incision transumbilical laproscopic surgery. Eur Surg 41:98–103CrossRef Brunner W, Schirnhofer J, Waldstein-Wartenberg N, Frass R, Pimpl K, Weiss H (2009) New: single-incision transumbilical laproscopic surgery. Eur Surg 41:98–103CrossRef
13.
go back to reference Franklin ME Jr, Ramos P, Rosenthal D, Schuessler W (1993) Laparoscopic colonic procedures. World J Surg 17:51–56CrossRefPubMed Franklin ME Jr, Ramos P, Rosenthal D, Schuessler W (1993) Laparoscopic colonic procedures. World J Surg 17:51–56CrossRefPubMed
14.
go back to reference Jones OM, Stevenson ARL, Clark D, Stitz RW, Lumley JW (2008) Laparoscopic resection for diverticular disease. Ann Surg 248:1092–1097CrossRefPubMed Jones OM, Stevenson ARL, Clark D, Stitz RW, Lumley JW (2008) Laparoscopic resection for diverticular disease. Ann Surg 248:1092–1097CrossRefPubMed
16.
go back to reference Chamberlain RS, Sakpal SV (2009) A comprehensive review of single-incision laparoscopic surgery (SILS) and natural orifice transluminal endoscopic surgery (NOTES) techniques for cholecystectomy. J Gastrointest Surg 13:1733–1740CrossRefPubMed Chamberlain RS, Sakpal SV (2009) A comprehensive review of single-incision laparoscopic surgery (SILS) and natural orifice transluminal endoscopic surgery (NOTES) techniques for cholecystectomy. J Gastrointest Surg 13:1733–1740CrossRefPubMed
17.
go back to reference Nguyen NT, Reavis KM, Hinojosa MW, Smith BR, Wilson SE (2009) Laparoscopic transumbilical cholecystectomy without visible abdominal scars. J Gastrointest Surg 13:1125–1128CrossRefPubMed Nguyen NT, Reavis KM, Hinojosa MW, Smith BR, Wilson SE (2009) Laparoscopic transumbilical cholecystectomy without visible abdominal scars. J Gastrointest Surg 13:1125–1128CrossRefPubMed
18.
go back to reference Hodgett SE, Hernandez JM, Morton CA, Ross SB, Albrink M, Rosemurgy AS (2009) Laparoendoscopic single-site (LESS) cholecystectomy. J Gastrointest Surg 13:188–192CrossRefPubMed Hodgett SE, Hernandez JM, Morton CA, Ross SB, Albrink M, Rosemurgy AS (2009) Laparoendoscopic single-site (LESS) cholecystectomy. J Gastrointest Surg 13:188–192CrossRefPubMed
Metadata
Title
Single-incision laparoscopic surgery: a promising approach to sigmoidectomy for diverticular disease
Authors
Boris Vestweber
Angelika Alfes
Claudia Paul
Franz Haaf
Karl-Heinz Vestweber
Publication date
01-12-2010
Publisher
Springer-Verlag
Published in
Surgical Endoscopy / Issue 12/2010
Print ISSN: 0930-2794
Electronic ISSN: 1432-2218
DOI
https://doi.org/10.1007/s00464-010-1090-2

Other articles of this Issue 12/2010

Surgical Endoscopy 12/2010 Go to the issue