Skip to main content
Top
Published in: Journal of Gastrointestinal Surgery 3/2012

01-03-2012 | Original Article

Safety, Feasibility, and Short-Term Outcomes of Single Port Access Colorectal Surgery: A Single Institutional Case-Matched Study

Authors: Sébastien Gaujoux, Léon Maggiori, Frédéric Bretagnol, Marianne Ferron, Yves Panis

Published in: Journal of Gastrointestinal Surgery | Issue 3/2012

Login to get access

Abstract

Background

Feasibility of single port access (SPA) colorectal surgery has been established for various procedures from ileocecal resection to proctectomy. Nevertheless, its benefits compared to conventional laparoscopy still need to be assess. The aim of this study was to compare SPA to conventional colorectal laparoscopic surgery in a single institutional case-matched study.

Methods

From July 2009 to July 2010, 25 SPA colorectal resections were matched on main predictive risk factors of postoperative complications, in a one to two fashion, with patient having the same procedure for the same indication by conventional laparoscopy.

Results

Patient characteristics were comparable between both groups. SPA was successfully performed in 24 of 25 patients, with a need to conversion to standard laparoscopy in one case (4%). SPA was associated with a significantly shorter median operative time (130 vs 180 min, p = 0.04) and hospital stay (6 vs 7 days, p = 0.005). Postoperative morbidity rates were similar between the two groups (4% vs 16%, p = 0.25).

Conclusion

SPA colorectal resection can be safely performed in selected patients with results comparable to those observed after conventional laparoscopic surgery. However, larger studies including randomized controlled trail are needed to demonstrate possible benefits of SPA colorectal resection over conventional colorectal laparoscopic surgery.
Literature
1.
go back to reference Bucher P, Pugin F, Morel P (2008) Single port access laparoscopic right hemicolectomy. Int J Colorectal Dis 23:1013–1016PubMedCrossRef Bucher P, Pugin F, Morel P (2008) Single port access laparoscopic right hemicolectomy. Int J Colorectal Dis 23:1013–1016PubMedCrossRef
2.
go back to reference Bucher P, Pugin F, Morel P (2010) Transumbilical single incision laparoscopic sigmoidectomy for benign disease. Colorectal Dis 12:61–65PubMedCrossRef Bucher P, Pugin F, Morel P (2010) Transumbilical single incision laparoscopic sigmoidectomy for benign disease. Colorectal Dis 12:61–65PubMedCrossRef
3.
go back to reference Ostrowitz MB, Eschete D, Zemon H, DeNoto G (2009) Robotic-assisted single-incision right colectomy: early experience. Int J Med Robot 5:465–470PubMedCrossRef Ostrowitz MB, Eschete D, Zemon H, DeNoto G (2009) Robotic-assisted single-incision right colectomy: early experience. Int J Med Robot 5:465–470PubMedCrossRef
4.
go back to reference Remzi FH, Kirat HT, Kaouk JH, Geisler DP (2008) Single-port laparoscopy in colorectal surgery. Colorectal Dis 10:823–826PubMedCrossRef Remzi FH, Kirat HT, Kaouk JH, Geisler DP (2008) Single-port laparoscopy in colorectal surgery. Colorectal Dis 10:823–826PubMedCrossRef
5.
go back to reference Merchant AM, Lin E (2009) Single-incision laparoscopic right hemicolectomy for a colon mass. Dis Colon Rectum 52:1021–1024PubMedCrossRef Merchant AM, Lin E (2009) Single-incision laparoscopic right hemicolectomy for a colon mass. Dis Colon Rectum 52:1021–1024PubMedCrossRef
6.
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 179PubMedCrossRef 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 179PubMedCrossRef
7.
go back to reference Rieger NA, Lam FF (2010) Single-incision laparoscopically assisted colectomy using standard laparoscopic instrumentation. Surg Endosc 24:888–890PubMedCrossRef Rieger NA, Lam FF (2010) Single-incision laparoscopically assisted colectomy using standard laparoscopic instrumentation. Surg Endosc 24:888–890PubMedCrossRef
8.
go back to reference Bucher P, Pugin F, Morel P (2009) Single-port access laparoscopic radical left colectomy in humans. Dis Colon Rectum 52:1797–1801PubMedCrossRef Bucher P, Pugin F, Morel P (2009) Single-port access laparoscopic radical left colectomy in humans. Dis Colon Rectum 52:1797–1801PubMedCrossRef
9.
go back to reference Geisler DP, Condon ET, Remzi FH (2010) Single incision laparoscopic total proctocolectomy with ileopouch anal anastomosis. Colorectal Dis 12:941–943PubMedCrossRef Geisler DP, Condon ET, Remzi FH (2010) Single incision laparoscopic total proctocolectomy with ileopouch anal anastomosis. Colorectal Dis 12:941–943PubMedCrossRef
10.
go back to reference Law WL, Fan JK, Poon JT (2010) Single incision laparoscopic left colectomy for carcinoma of distal transverse colon. Colorectal Dis 12:698–701PubMedCrossRef Law WL, Fan JK, Poon JT (2010) Single incision laparoscopic left colectomy for carcinoma of distal transverse colon. Colorectal Dis 12:698–701PubMedCrossRef
11.
go back to reference Remzi FH, Kirat HT, Geisler DP (2010) Laparoscopic single-port colectomy for sigmoid cancer. Tech Coloproctol 14:253–255PubMedCrossRef Remzi FH, Kirat HT, Geisler DP (2010) Laparoscopic single-port colectomy for sigmoid cancer. Tech Coloproctol 14:253–255PubMedCrossRef
12.
go back to reference Law WL, Fan JK, Poon JT (2010) Single-incision laparoscopic colectomy: early experience. Dis Colon Rectum 53:284–288PubMedCrossRef Law WL, Fan JK, Poon JT (2010) Single-incision laparoscopic colectomy: early experience. Dis Colon Rectum 53:284–288PubMedCrossRef
13.
go back to reference Chambers W, Bicsak M, Lamparelli M, Dixon A (2011) Single-incision laparoscopic surgery (SILS) in complex colorectal surgery: a technique offering potential and not just cosmesis. Colorectal Dis 13;393–8 Chambers W, Bicsak M, Lamparelli M, Dixon A (2011) Single-incision laparoscopic surgery (SILS) in complex colorectal surgery: a technique offering potential and not just cosmesis. Colorectal Dis 13;393–8
14.
go back to reference Ross H, Steele S, Whiteford M, Lee S, Albert M, Mutch M, Rivadeneira D, Marcello P (2011) Early multi-institution experience with single-incision laparoscopic colectomy. Dis Colon Rectum 54:187–192PubMedCrossRef Ross H, Steele S, Whiteford M, Lee S, Albert M, Mutch M, Rivadeneira D, Marcello P (2011) Early multi-institution experience with single-incision laparoscopic colectomy. Dis Colon Rectum 54:187–192PubMedCrossRef
15.
go back to reference Pfluke JM, Parker M, Stauffer JA, Paetau AA, Bowers SP, Asbun HJ, Smith CD (2011) Laparoscopic surgery performed through a single incision: a systematic review of the current literature. J Am Coll Surg 212:113–118PubMedCrossRef Pfluke JM, Parker M, Stauffer JA, Paetau AA, Bowers SP, Asbun HJ, Smith CD (2011) Laparoscopic surgery performed through a single incision: a systematic review of the current literature. J Am Coll Surg 212:113–118PubMedCrossRef
16.
go back to reference Leblanc F, Makhija R, Champagne BJ, Delaney CP (2011) Single incision laparoscopic total colectomy and proctocolectomy for benign disease-Initial experience. Colorectal Dis 13;1290–3 Leblanc F, Makhija R, Champagne BJ, Delaney CP (2011) Single incision laparoscopic total colectomy and proctocolectomy for benign disease-Initial experience. Colorectal Dis 13;1290–3
17.
go back to reference Keshava A, Young CJ, Mackenzie S (2010) Single-incision laparoscopic right hemicolectomy. Br J Surg 97:1881–1883PubMedCrossRef Keshava A, Young CJ, Mackenzie S (2010) Single-incision laparoscopic right hemicolectomy. Br J Surg 97:1881–1883PubMedCrossRef
18.
go back to reference Boni L, Dionigi G, Cassinotti E, Di Giuseppe M, Diurni M, Rausei S, Cantore F, Dionigi R (2010) Single incision laparoscopic right colectomy. Surg Endosc 24:3233–3236PubMedCrossRef Boni L, Dionigi G, Cassinotti E, Di Giuseppe M, Diurni M, Rausei S, Cantore F, Dionigi R (2010) Single incision laparoscopic right colectomy. Surg Endosc 24:3233–3236PubMedCrossRef
19.
go back to reference Ahmed K, Wang TT, Patel VM, Nagpal K, Clark J, Ali M, Deeba S, Ashrafian H, Darzi A, Athanasiou T, Paraskeva P (2011) The role of single-incision laparoscopic surgery in abdominal and pelvic surgery: a systematic review. Surg Endosc 25:378–396PubMedCrossRef Ahmed K, Wang TT, Patel VM, Nagpal K, Clark J, Ali M, Deeba S, Ashrafian H, Darzi A, Athanasiou T, Paraskeva P (2011) The role of single-incision laparoscopic surgery in abdominal and pelvic surgery: a systematic review. Surg Endosc 25:378–396PubMedCrossRef
20.
go back to reference Ramos-Valadez DI, Patel CB, Ragupathi M, Bartley Pickron T, Haas EM (2010) Single-incision laparoscopic right hemicolectomy: safety and feasibility in a series of consecutive cases. Surg Endosc 24:2613–2616PubMedCrossRef Ramos-Valadez DI, Patel CB, Ragupathi M, Bartley Pickron T, Haas EM (2010) Single-incision laparoscopic right hemicolectomy: safety and feasibility in a series of consecutive cases. Surg Endosc 24:2613–2616PubMedCrossRef
21.
go back to reference Fronza JS, Linn JG, Nagle AP, Soper NJ (2010) A single institution’s experience with single incision cholecystectomy compared to standard laparoscopic cholecystectomy. Surgery 148:731–734; discussion 734–736PubMedCrossRef Fronza JS, Linn JG, Nagle AP, Soper NJ (2010) A single institution’s experience with single incision cholecystectomy compared to standard laparoscopic cholecystectomy. Surgery 148:731–734; discussion 734–736PubMedCrossRef
22.
go back to reference Lee PC, Lo C, Lai PS, Chang JJ, Huang SJ, Lin MT, Lee PH (2010) Randomized clinical trial of single-incision laparoscopic cholecystectomy versus minilaparoscopic cholecystectomy. Br J Surg 97:1007–1012PubMedCrossRef Lee PC, Lo C, Lai PS, Chang JJ, Huang SJ, Lin MT, Lee PH (2010) Randomized clinical trial of single-incision laparoscopic cholecystectomy versus minilaparoscopic cholecystectomy. Br J Surg 97:1007–1012PubMedCrossRef
23.
go back to reference Tsimoyiannis EC, Tsimogiannis KE, Pappas-Gogos G, Farantos C, Benetatos N, Mavridou P, Manataki A (2010) Different pain scores in single transumbilical incision laparoscopic cholecystectomy versus classic laparoscopic cholecystectomy: a randomized controlled trial. Surg Endosc 24:1842–1848PubMedCrossRef Tsimoyiannis EC, Tsimogiannis KE, Pappas-Gogos G, Farantos C, Benetatos N, Mavridou P, Manataki A (2010) Different pain scores in single transumbilical incision laparoscopic cholecystectomy versus classic laparoscopic cholecystectomy: a randomized controlled trial. Surg Endosc 24:1842–1848PubMedCrossRef
24.
go back to reference Chow A, Purkayastha S, Nehme J, Darzi LA, Paraskeva P (2010) Single incision laparoscopic surgery for appendicectomy: a retrospective comparative analysis. Surg Endosc 24:2567–2574PubMedCrossRef Chow A, Purkayastha S, Nehme J, Darzi LA, Paraskeva P (2010) Single incision laparoscopic surgery for appendicectomy: a retrospective comparative analysis. Surg Endosc 24:2567–2574PubMedCrossRef
25.
go back to reference Raman JD, Bagrodia A, Cadeddu JA (2009) Single-incision, umbilical laparoscopic versus conventional laparoscopic nephrectomy: a comparison of perioperative outcomes and short-term measures of convalescence. Eur Urol 55:1198–1204PubMedCrossRef Raman JD, Bagrodia A, Cadeddu JA (2009) Single-incision, umbilical laparoscopic versus conventional laparoscopic nephrectomy: a comparison of perioperative outcomes and short-term measures of convalescence. Eur Urol 55:1198–1204PubMedCrossRef
26.
go back to reference Canes D, Berger A, Aron M, Brandina R, Goldfarb DA, Shoskes D, Desai MM, Gill IS (2010) Laparo-endoscopic single site (LESS) versus standard laparoscopic left donor nephrectomy: matched-pair comparison. Eur Urol 57:95–101PubMedCrossRef Canes D, Berger A, Aron M, Brandina R, Goldfarb DA, Shoskes D, Desai MM, Gill IS (2010) Laparo-endoscopic single site (LESS) versus standard laparoscopic left donor nephrectomy: matched-pair comparison. Eur Urol 57:95–101PubMedCrossRef
27.
go back to reference Gandhi DP, Ragupathi M, Patel CB, Ramos-Valadez DI, Pickron TB, Haas EM (2010) Single-incision versus hand-assisted laparoscopic colectomy: a case-matched series. J Gastrointest Surg 14:1875–1880PubMedCrossRef Gandhi DP, Ragupathi M, Patel CB, Ramos-Valadez DI, Pickron TB, Haas EM (2010) Single-incision versus hand-assisted laparoscopic colectomy: a case-matched series. J Gastrointest Surg 14:1875–1880PubMedCrossRef
28.
go back to reference Champagne BJ, Lee EC, Leblanc F, Stein SL, Delaney CP (2011) Single-incision vs straight laparoscopic segmental colectomy: a case-controlled study. Dis Colon Rectum 54:183–186PubMedCrossRef Champagne BJ, Lee EC, Leblanc F, Stein SL, Delaney CP (2011) Single-incision vs straight laparoscopic segmental colectomy: a case-controlled study. Dis Colon Rectum 54:183–186PubMedCrossRef
29.
go back to reference Waters JA, Guzman MJ, Fajardo AD, Selzer DJ, Wiebke EA, Robb BW, George VV (2010) Single-port laparoscopic right hemicolectomy: a safe alternative to conventional laparoscopy. Dis Colon Rectum 53:1467–1472PubMedCrossRef Waters JA, Guzman MJ, Fajardo AD, Selzer DJ, Wiebke EA, Robb BW, George VV (2010) Single-port laparoscopic right hemicolectomy: a safe alternative to conventional laparoscopy. Dis Colon Rectum 53:1467–1472PubMedCrossRef
30.
go back to reference Adair J, Gromski MA, Lim RB, Nagle D (2010) Single-incision laparoscopic right colectomy: experience with 17 consecutive cases and comparison with multiport laparoscopic right colectomy. Dis Colon Rectum 53:1549–1554PubMedCrossRef Adair J, Gromski MA, Lim RB, Nagle D (2010) Single-incision laparoscopic right colectomy: experience with 17 consecutive cases and comparison with multiport laparoscopic right colectomy. Dis Colon Rectum 53:1549–1554PubMedCrossRef
31.
go back to reference Chen WT, Chang SC, Chiang HC, Lo WY, Jeng LB, Wu C, Ke TW (2011) Single-incision laparoscopic versus conventional laparoscopic right hemicolectomy: a comparison of short-term surgical results. Surg Endosc 25:1887–1892PubMedCrossRef Chen WT, Chang SC, Chiang HC, Lo WY, Jeng LB, Wu C, Ke TW (2011) Single-incision laparoscopic versus conventional laparoscopic right hemicolectomy: a comparison of short-term surgical results. Surg Endosc 25:1887–1892PubMedCrossRef
32.
go back to reference Papaconstantinou HT, Sharp N, Thomas JS (2011) Single-incision laparoscopic right colectomy: a case-matched comparison with standard laparoscopic and hand-assisted laparoscopic techniques. J Am Coll Surg 213:72–80PubMedCrossRef Papaconstantinou HT, Sharp N, Thomas JS (2011) Single-incision laparoscopic right colectomy: a case-matched comparison with standard laparoscopic and hand-assisted laparoscopic techniques. J Am Coll Surg 213:72–80PubMedCrossRef
33.
go back to reference Gaujoux S, Bretagnol F, Ferron M, Panis Y (2011) Single incision laparoscopic colonic surgery (SILS). Colorectal Dis 13(9):1066–1071 Gaujoux S, Bretagnol F, Ferron M, Panis Y (2011) Single incision laparoscopic colonic surgery (SILS). Colorectal Dis 13(9):1066–1071
34.
go back to reference Alves A, Panis Y, Bouhnik Y, Pocard M, Vicaut E, Valleur P (2007) Risk factors for intra-abdominal septic complications after a first ileocecal resection for Crohn’s disease: a multivariate analysis in 161 consecutive patients. Dis Colon Rectum 50:331–336PubMedCrossRef Alves A, Panis Y, Bouhnik Y, Pocard M, Vicaut E, Valleur P (2007) Risk factors for intra-abdominal septic complications after a first ileocecal resection for Crohn’s disease: a multivariate analysis in 161 consecutive patients. Dis Colon Rectum 50:331–336PubMedCrossRef
35.
go back to reference Alves A, Panis Y, Slim K, Heyd B, Kwiatkowski F, Mantion G (2005) French multicentre prospective observational study of laparoscopic versus open colectomy for sigmoid diverticular disease. Br J Surg 92:1520–1525PubMedCrossRef Alves A, Panis Y, Slim K, Heyd B, Kwiatkowski F, Mantion G (2005) French multicentre prospective observational study of laparoscopic versus open colectomy for sigmoid diverticular disease. Br J Surg 92:1520–1525PubMedCrossRef
36.
go back to reference Bretagnol F, Alves A, Ricci A, Valleur P, Panis Y (2007) Rectal cancer surgery without mechanical bowel preparation. Br J Surg 94:1266–1271PubMedCrossRef Bretagnol F, Alves A, Ricci A, Valleur P, Panis Y (2007) Rectal cancer surgery without mechanical bowel preparation. Br J Surg 94:1266–1271PubMedCrossRef
37.
go back to reference (1995) Physical status: the use and the interpretation of anthropometry: report of a WHO expert committee. World Health Organ Tech Rep Ser:1–452 (1995) Physical status: the use and the interpretation of anthropometry: report of a WHO expert committee. World Health Organ Tech Rep Ser:1–452
38.
go back to reference Alves A, Panis Y, Mathieu P, Mantion G, Kwiatkowski F, Slim K (2005) Postoperative mortality and morbidity in French patients undergoing colorectal surgery: results of a prospective multicenter study. Arch Surg 140:278–283, discussion 284PubMedCrossRef Alves A, Panis Y, Mathieu P, Mantion G, Kwiatkowski F, Slim K (2005) Postoperative mortality and morbidity in French patients undergoing colorectal surgery: results of a prospective multicenter study. Arch Surg 140:278–283, discussion 284PubMedCrossRef
39.
go back to reference Alves A, Panis Y, Mantion G, Slim K, Kwiatkowski F, Vicaut E (2007) The AFC score: validation of a 4-item predicting score of postoperative mortality after colorectal resection for cancer or diverticulitis: results of a prospective multicenter study in 1049 patients. Ann Surg 246:91–96PubMedCrossRef Alves A, Panis Y, Mantion G, Slim K, Kwiatkowski F, Vicaut E (2007) The AFC score: validation of a 4-item predicting score of postoperative mortality after colorectal resection for cancer or diverticulitis: results of a prospective multicenter study in 1049 patients. Ann Surg 246:91–96PubMedCrossRef
40.
go back to reference Dindo D, Demartines N, Clavien PA (2004) Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann Surg 240:205–213PubMedCrossRef Dindo D, Demartines N, Clavien PA (2004) Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann Surg 240:205–213PubMedCrossRef
41.
go back to reference Aldrighetti L, Guzzetti E, Ferla G (2011) Laparoscopic hepatic left lateral sectionectomy using the LaparoEndoscopic Single Site approach: evolution of minimally invasive liver surgery. J Hepatobiliary Pancreat Sci 18:103–105PubMedCrossRef Aldrighetti L, Guzzetti E, Ferla G (2011) Laparoscopic hepatic left lateral sectionectomy using the LaparoEndoscopic Single Site approach: evolution of minimally invasive liver surgery. J Hepatobiliary Pancreat Sci 18:103–105PubMedCrossRef
42.
go back to reference Gaujoux S, Kingham TP, Jarnagin WR, D’Angelica MI, Allen PJ, Fong Y (2010) Single-incision laparoscopic liver resection. Surg Endosc Gaujoux S, Kingham TP, Jarnagin WR, D’Angelica MI, Allen PJ, Fong Y (2010) Single-incision laparoscopic liver resection. Surg Endosc
43.
go back to reference Lee YS, Kim JH, Moon EJ, Kim JJ, Lee KH, Oh SJ, Park SM, Hong TH (2009) Comparative study on surgical outcomes and operative costs of transumbilical single-port laparoscopic appendectomy versus conventional laparoscopic appendectomy in adult patients. Surg Laparosc Endosc Percutan Tech 19:493–496PubMedCrossRef Lee YS, Kim JH, Moon EJ, Kim JJ, Lee KH, Oh SJ, Park SM, Hong TH (2009) Comparative study on surgical outcomes and operative costs of transumbilical single-port laparoscopic appendectomy versus conventional laparoscopic appendectomy in adult patients. Surg Laparosc Endosc Percutan Tech 19:493–496PubMedCrossRef
44.
go back to reference Santos BF, Enter D, Soper NJ, Hungness ES (2011) Single-incision laparoscopic surgery (SILS) versus standard laparoscopic surgery: a comparison of performance using a surgical simulator. Surg Endosc 25:483–490PubMedCrossRef Santos BF, Enter D, Soper NJ, Hungness ES (2011) Single-incision laparoscopic surgery (SILS) versus standard laparoscopic surgery: a comparison of performance using a surgical simulator. Surg Endosc 25:483–490PubMedCrossRef
45.
go back to reference Maeda T, Tan KY, Konishi F, Tsujinaka S, Mizokami K, Sasaki J, Kawamura YJ (2009) Trainee surgeons do not cause more conversions in laparoscopic colorectal surgery if they are well supervised. World J Surg 33:2439–2443PubMedCrossRef Maeda T, Tan KY, Konishi F, Tsujinaka S, Mizokami K, Sasaki J, Kawamura YJ (2009) Trainee surgeons do not cause more conversions in laparoscopic colorectal surgery if they are well supervised. World J Surg 33:2439–2443PubMedCrossRef
Metadata
Title
Safety, Feasibility, and Short-Term Outcomes of Single Port Access Colorectal Surgery: A Single Institutional Case-Matched Study
Authors
Sébastien Gaujoux
Léon Maggiori
Frédéric Bretagnol
Marianne Ferron
Yves Panis
Publication date
01-03-2012
Publisher
Springer-Verlag
Published in
Journal of Gastrointestinal Surgery / Issue 3/2012
Print ISSN: 1091-255X
Electronic ISSN: 1873-4626
DOI
https://doi.org/10.1007/s11605-011-1780-7

Other articles of this Issue 3/2012

Journal of Gastrointestinal Surgery 3/2012 Go to the issue