Single port laparoscopic right colonic resection using a 'vessel-first' approach

Colorectal Dis. 2012 Sep;14(9):1138-44. doi: 10.1111/j.1463-1318.2011.02898.x.

Abstract

Aim: Single port laparoscopic colorectal surgery (SPLC), performed through a single incision of ≤ 3 cm, has been shown to be feasible. This study aimed to assess its safety and efficacy when used as the method of choice for right hemicolectomy.

Method: A prospective study was carried out of patients undergoing right hemicolectomy using a single port laparoscopic technique. They were compared with a historical series of patients undergoing right hemicolectomy using a multiport laparoscopic technique. Between December 2009 and September 2010, single port surgery replaced conventional laparoscopic colorectal surgery (LCS) for radical medial to lateral right hemicolectomy performed by a single surgeon. Histology, length of hospital stay, complications, conversions and readmissions were recorded.

Results: Fourteen patients were treated using single port laparoscopic surgery (SPLC): 10 for carcinoma (Dukes A1, B6, C3) and four for Crohn's disease. Twelve patients were treated using multiport laparoscopic colorectal surgery (LCS): eight for carcinoma (Dukes B4, C3, Carcinoid 1), three for Crohn's disease and one for adenoma. The median (interquartile range) operative time for the SPLC group was 120 (90-135) min and for the LCS group was 135 (116-150) min. The median (interquartile range) length of hospital stay was 3.5 (2.0-5.0) days for the SPLC group and for the LCS group was 4.0 (3.8-7.0) days. The median (interquartile range) number of lymph nodes removed for SPLC patients was 14.5 (9.8-19.5) and for the LCS patients was 14.5 (13.0-19.5). There were no conversions, no complications and no readmissions in either group.

Conclusion: These data confirm the feasibility of the technique. Furthermore they suggest that it is safe and efficacious.

MeSH terms

  • Adenoma / surgery*
  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Carcinoma / surgery*
  • Case-Control Studies
  • Colectomy / methods*
  • Colon, Ascending / surgery*
  • Colorectal Neoplasms / surgery*
  • Crohn Disease / surgery
  • Female
  • Humans
  • Laparoscopy / methods*
  • Length of Stay
  • Ligation
  • Male
  • Middle Aged
  • Operative Time
  • Prospective Studies