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Published in: Surgical Endoscopy 6/2012

01-06-2012

Single-incision laparoscopic right colectomy in an unselected patient population

Authors: Brian A. Boone, Patrick Wagner, Emily Ganchuk, Leonard Evans, Herb J. Zeh, David L. Bartlett, Matthew P. Holtzman

Published in: Surgical Endoscopy | Issue 6/2012

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Abstract

Background

Single-incision laparoscopic surgery has become increasingly utilized for colorectal surgery, with the most frequently reported single-incision laparoscopic operation being right hemicolectomy. While current data suggest that single-incision laparoscopic right colectomy is feasible, safe, and roughly equivalent to standard laparoscopic right colectomy, the technique has to date only been described in highly selected patients. Single-incision laparoscopic right colectomy has not yet been assessed in a standard patient population.

Methods

A retrospective review was conducted to evaluate all single-incision right hemicolectomies performed by a single surgeon between May 2010 and April 2011. Demographic data, operative parameters, and postoperative outcomes were assessed.

Results

Single-incision laparoscopic colectomy was performed in a series of 30 consecutive patients with indications for right colectomy. One patient required conversion to an open procedure for extensive adhesions, while no patients required additional port placement. Mean operative time was 107 min. All patients had negative margins and had an average of 20 lymph nodes harvested. Mean length of stay was 6 days. There were no intraoperative complications and no mortality in the study. The perioperative complication rate was 37%, with 71% of complications being grade 1.

Conclusions

Single-incision laparoscopic colectomy is feasible, safe, efficient, and oncologically sound for most patients who are seen in a typical colorectal practice. These data are useful as single-incision laparoscopic colectomy becomes more broadly implemented.
Literature
1.
go back to reference Jacobs M, Verdeja JC, Goldstein HS (1991) Minimally invasive colon resection (laparoscopic colectomy). Surg Laparosc Endosc 1(3):144–150PubMed Jacobs M, Verdeja JC, Goldstein HS (1991) Minimally invasive colon resection (laparoscopic colectomy). Surg Laparosc Endosc 1(3):144–150PubMed
2.
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(20):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(20):2050–2059CrossRef
3.
go back to reference Guillou PJ, Quirke P, Thorpe H, Walker J, Jayne DG, Smith AM, Heath RM, Brown JM (2005) Short-term endpoints of conventional versus laparoscopic-assisted surgery in patients with colorectal cancer (MRC CLASICC trial): multicentre, randomised controlled trial. Lancet 365(9472):1718–1726PubMedCrossRef Guillou PJ, Quirke P, Thorpe H, Walker J, Jayne DG, Smith AM, Heath RM, Brown JM (2005) Short-term endpoints of conventional versus laparoscopic-assisted surgery in patients with colorectal cancer (MRC CLASICC trial): multicentre, randomised controlled trial. Lancet 365(9472):1718–1726PubMedCrossRef
4.
go back to reference Jackson TD, Kaplan GG, Arena G, Page JH, Rogers SO Jr (2007) Laparoscopic versus open resection for colorectal cancer: a metaanalysis of oncologic outcomes. J Am Coll Surg 204(3):439–446PubMedCrossRef Jackson TD, Kaplan GG, Arena G, Page JH, Rogers SO Jr (2007) Laparoscopic versus open resection for colorectal cancer: a metaanalysis of oncologic outcomes. J Am Coll Surg 204(3):439–446PubMedCrossRef
5.
go back to reference Kuhry E, Schwenk W, Gaupset R, Romild U, Bonjer J (2008) Long-term outcome of laparoscopic surgery for colorectal cancer: a Cochrane systematic review of randomised controlled trials. Cancer Treat Rev 34(6):498–504PubMedCrossRef Kuhry E, Schwenk W, Gaupset R, Romild U, Bonjer J (2008) Long-term outcome of laparoscopic surgery for colorectal cancer: a Cochrane systematic review of randomised controlled trials. Cancer Treat Rev 34(6):498–504PubMedCrossRef
6.
go back to reference Veldkamp R, Kuhry E, Hop WC, Jeekel J, Kazemier G, Bonjer HJ, Haglind E, Pahlman L, Cuesta MA, Msika S, Morino M, Lacy AM (2005) Laparoscopic surgery versus open surgery for colon cancer: short-term outcomes of a randomised trial. Lancet Oncol 6(7):477–484PubMedCrossRef Veldkamp R, Kuhry E, Hop WC, Jeekel J, Kazemier G, Bonjer HJ, Haglind E, Pahlman L, Cuesta MA, Msika S, Morino M, Lacy AM (2005) Laparoscopic surgery versus open surgery for colon cancer: short-term outcomes of a randomised trial. Lancet Oncol 6(7):477–484PubMedCrossRef
7.
go back to reference Leblanc F, Champagne BJ, Augestad KM, Stein SL, Marderstein E, Reynolds HL, Delaney CP (2010) Single incision laparoscopic colectomy: technical aspects, feasibility, and expected benefits. Diagn Ther Endosc 2010:913216PubMedCrossRef Leblanc F, Champagne BJ, Augestad KM, Stein SL, Marderstein E, Reynolds HL, Delaney CP (2010) Single incision laparoscopic colectomy: technical aspects, feasibility, and expected benefits. Diagn Ther Endosc 2010:913216PubMedCrossRef
8.
go back to reference Pelosi MA, Pelosi MA 3rd (1992) Laparoscopic appendectomy using a single umbilical puncture (minilaparoscopy). J Reprod Med 37(7):588–594PubMed Pelosi MA, Pelosi MA 3rd (1992) Laparoscopic appendectomy using a single umbilical puncture (minilaparoscopy). J Reprod Med 37(7):588–594PubMed
9.
go back to reference Navarra G, Pozza E, Occhionorelli S, Carcoforo P, Donini I (1997) One-wound laparoscopic cholecystectomy. Br J Surg 84(5):695PubMedCrossRef Navarra G, Pozza E, Occhionorelli S, Carcoforo P, Donini I (1997) One-wound laparoscopic cholecystectomy. Br J Surg 84(5):695PubMedCrossRef
10.
go back to reference Piskun G, Rajpal S (1999) Transumbilical laparoscopic cholecystectomy utilizes no incisions outside the umbilicus. J Laparoendosc Adv Surg Tech A 9(4):361–364PubMedCrossRef Piskun G, Rajpal S (1999) Transumbilical laparoscopic cholecystectomy utilizes no incisions outside the umbilicus. J Laparoendosc Adv Surg Tech A 9(4):361–364PubMedCrossRef
11.
go back to reference Chambers WM, Bicsak M, Lamparelli M, Dixon AR (2011) Single-incision laparoscopic surgery (SILS) in complex colorectal surgery: a technique offering potential and not just cosmesis. Colorectal Dis 13(4):393–398PubMedCrossRef Chambers WM, Bicsak M, Lamparelli M, Dixon AR (2011) Single-incision laparoscopic surgery (SILS) in complex colorectal surgery: a technique offering potential and not just cosmesis. Colorectal Dis 13(4):393–398PubMedCrossRef
12.
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(2):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(2):183–186PubMedCrossRef
13.
go back to reference Gash KJ, Goede AC, Chambers W, Greenslade GL, Dixon AR (2011) Laparoendoscopic single-site surgery is feasible in complex colorectal resections and could enable day case colectomy. Surg Endosc 25(3):835–840PubMedCrossRef Gash KJ, Goede AC, Chambers W, Greenslade GL, Dixon AR (2011) Laparoendoscopic single-site surgery is feasible in complex colorectal resections and could enable day case colectomy. Surg Endosc 25(3):835–840PubMedCrossRef
14.
go back to reference Ishida H, Okada N, Ishibashi K, Ohsawa T, Kumamoto K, Haga N (2011) Single-incision laparoscopic-assisted surgery for colon cancer via a periumbilical approach using a surgical glove: initial experience with 9 cases. Int J Surg 9(2):150–154PubMedCrossRef Ishida H, Okada N, Ishibashi K, Ohsawa T, Kumamoto K, Haga N (2011) Single-incision laparoscopic-assisted surgery for colon cancer via a periumbilical approach using a surgical glove: initial experience with 9 cases. Int J Surg 9(2):150–154PubMedCrossRef
15.
go back to reference Law WL, Fan JK, Poon JT (2010) Single-incision laparoscopic colectomy: early experience. Dis Colon Rectum 53(3):284–288PubMedCrossRef Law WL, Fan JK, Poon JT (2010) Single-incision laparoscopic colectomy: early experience. Dis Colon Rectum 53(3):284–288PubMedCrossRef
16.
go back to reference Rieger NA, Lam FF (2010) Single-incision laparoscopically assisted colectomy using standard laparoscopic instrumentation. Surg Endosc 24(4):888–890PubMedCrossRef Rieger NA, Lam FF (2010) Single-incision laparoscopically assisted colectomy using standard laparoscopic instrumentation. Surg Endosc 24(4):888–890PubMedCrossRef
17.
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(2):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(2):187–192PubMedCrossRef
18.
go back to reference Uematsu D, Akiyama G, Magishi A, Nakamura J, Hotta K (2010) Single-access laparoscopic left and right hemicolectomy combined with extracorporeal magnetic retraction. Dis Colon Rectum 53(6):944–948PubMedCrossRef Uematsu D, Akiyama G, Magishi A, Nakamura J, Hotta K (2010) Single-access laparoscopic left and right hemicolectomy combined with extracorporeal magnetic retraction. Dis Colon Rectum 53(6):944–948PubMedCrossRef
19.
go back to reference Bucher P, Pugin F, Morel P (2008) Single port access laparoscopic right hemicolectomy. Int J Colorectal Dis 23(10):1013–1016PubMedCrossRef Bucher P, Pugin F, Morel P (2008) Single port access laparoscopic right hemicolectomy. Int J Colorectal Dis 23(10):1013–1016PubMedCrossRef
20.
go back to reference Remzi FH, Kirat HT, Kaouk JH, Geisler DP (2008) Single-port laparoscopy in colorectal surgery. Colorectal Dis 10(8):823–826PubMedCrossRef Remzi FH, Kirat HT, Kaouk JH, Geisler DP (2008) Single-port laparoscopy in colorectal surgery. Colorectal Dis 10(8):823–826PubMedCrossRef
21.
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(12):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(12):3233–3236PubMedCrossRef
22.
go back to reference Choi SI, Lee KY, Park SJ, Lee SH (2010) Single port laparoscopic right hemicolectomy with D3 dissection for advanced colon cancer. World J Gastroenterol 16(2):275–278PubMedCrossRef Choi SI, Lee KY, Park SJ, Lee SH (2010) Single port laparoscopic right hemicolectomy with D3 dissection for advanced colon cancer. World J Gastroenterol 16(2):275–278PubMedCrossRef
23.
go back to reference Chow AG, Purkayastha S, Zacharakis E, Paraskeva P (2011) Single-incision laparoscopic surgery for right hemicolectomy. Arch Surg 146(2):183–186PubMedCrossRef Chow AG, Purkayastha S, Zacharakis E, Paraskeva P (2011) Single-incision laparoscopic surgery for right hemicolectomy. Arch Surg 146(2):183–186PubMedCrossRef
24.
go back to reference Keshava A, Young CJ, Mackenzie S (2010) Single-incision laparoscopic right hemicolectomy. Br J Surg 97(12):1881–1883PubMedCrossRef Keshava A, Young CJ, Mackenzie S (2010) Single-incision laparoscopic right hemicolectomy. Br J Surg 97(12):1881–1883PubMedCrossRef
25.
go back to reference Morales-Conde S, Moreno JG, Gomez JC, Socas M, Barranco A, Alarcon I, Casado M, Cadet JM, Martin-Cartes J (2010) Total intracorporeal anastomosis during single-port laparoscopic right hemicolectomy for carcinoma of colon: a new step forward. Surg Innov 17(3):226–228PubMedCrossRef Morales-Conde S, Moreno JG, Gomez JC, Socas M, Barranco A, Alarcon I, Casado M, Cadet JM, Martin-Cartes J (2010) Total intracorporeal anastomosis during single-port laparoscopic right hemicolectomy for carcinoma of colon: a new step forward. Surg Innov 17(3):226–228PubMedCrossRef
26.
go back to reference Patel CB, Ramos-Valadez DI, Ragupathi M, Haas EM (2010) Single incision laparoscopic-assisted right hemicolectomy: technique and application (with video). Surg Laparosc Endosc Percutan Tech 20(5):e146–e149PubMedCrossRef Patel CB, Ramos-Valadez DI, Ragupathi M, Haas EM (2010) Single incision laparoscopic-assisted right hemicolectomy: technique and application (with video). Surg Laparosc Endosc Percutan Tech 20(5):e146–e149PubMedCrossRef
27.
go back to reference Pietrasanta D, Romano N, Prosperi V, Lorenzetti L, Basili G, Goletti O (2010) Single-incision laparoscopic right colectomy for cancer: a single-centre preliminary experience. Updates Surg 62(2):111–115PubMedCrossRef Pietrasanta D, Romano N, Prosperi V, Lorenzetti L, Basili G, Goletti O (2010) Single-incision laparoscopic right colectomy for cancer: a single-centre preliminary experience. Updates Surg 62(2):111–115PubMedCrossRef
28.
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(10):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(10):2613–2616PubMedCrossRef
29.
go back to reference Wong MT, Ng KH, Ho KS, Eu KW (2010) Single-incision laparoscopic surgery for right hemicolectomy: our initial experience with 10 cases. Tech Coloproctol 14(3):225–228PubMedCrossRef Wong MT, Ng KH, Ho KS, Eu KW (2010) Single-incision laparoscopic surgery for right hemicolectomy: our initial experience with 10 cases. Tech Coloproctol 14(3):225–228PubMedCrossRef
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(11):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(11):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(6):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(6):1887–1892PubMedCrossRef
32.
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(11):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(11):1467–1472PubMedCrossRef
33.
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(2):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(2):205–213PubMedCrossRef
34.
go back to reference Liang Y, Li G, Chen P, Yu J (2008) Laparoscopic versus open colorectal resection for cancer: a meta-analysis of results of randomized controlled trials on recurrence. Eur J Surg Oncol 34(11):1217–1224PubMedCrossRef Liang Y, Li G, Chen P, Yu J (2008) Laparoscopic versus open colorectal resection for cancer: a meta-analysis of results of randomized controlled trials on recurrence. Eur J Surg Oncol 34(11):1217–1224PubMedCrossRef
35.
go back to reference Lim YK, Ng KH, Eu KW (2010) Single site laparoscopic right hemicolectomy: an oncological feasible option. World J Surg Oncol 8:79PubMedCrossRef Lim YK, Ng KH, Eu KW (2010) Single site laparoscopic right hemicolectomy: an oncological feasible option. World J Surg Oncol 8:79PubMedCrossRef
36.
go back to reference Chandler NM, Danielson PD (2011) Single-incision laparoscopic cholecystectomy in children: a retrospective comparison with traditional laparoscopic cholecystectomy. J Pediatr Surg 46(9):1695–1699PubMedCrossRef Chandler NM, Danielson PD (2011) Single-incision laparoscopic cholecystectomy in children: a retrospective comparison with traditional laparoscopic cholecystectomy. J Pediatr Surg 46(9):1695–1699PubMedCrossRef
Metadata
Title
Single-incision laparoscopic right colectomy in an unselected patient population
Authors
Brian A. Boone
Patrick Wagner
Emily Ganchuk
Leonard Evans
Herb J. Zeh
David L. Bartlett
Matthew P. Holtzman
Publication date
01-06-2012
Publisher
Springer-Verlag
Published in
Surgical Endoscopy / Issue 6/2012
Print ISSN: 0930-2794
Electronic ISSN: 1432-2218
DOI
https://doi.org/10.1007/s00464-011-2076-4

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