Advertisement

Single incision laparoscopic right colectomy

  • 280 Accesses

  • 93 Citations

Abstract

Objective

This study was designed to describe the surgical technique for single-incision laparoscopic right colectomy and present preliminary short-term results. Laparoscopic surgery has been fully validated as alternative, minimally invasive treatment for different benign and malignant conditions. In the attempt to reduce even more the surgical trauma, natural orifices transluminal endoscopic surgery (NOTES™) and single-incision laparoscopic surgery (SILS) have been proposed. Although the lack of proper instrumentations makes NOTES™ not fully suitable for advanced procedures, SILS might play a significant role, although, to date, only limited series and few case reports of single-incision right colectomy are present in the literature.

Methods

After signed, informed consent was obtained, patients with malignant tumors or large polyps of the right colon underwent single-incision colonic resection through a 3-cm incision using two different single-port devices and articulated or coaxial curved instruments. Preliminary results were analyzed retrospectively.

Results

A total of 36 patients were selected for SILS procedure. There were no intraoperative complications or conversions to the standard laparoscopic procedure. One patient had a postoperative urinary tract infection and one prolonged ileum that did not required any surgical intervention. No complications were reported in all the remaining cases. The mean postoperative stay was 5 ± 1.2 days (range, 4–14), and mean lymph node retrieval and tumor-free margins was 24 ± 7 (range, 29–15) and 8 ± 3 (range, 6–12) cm, respectively.

Conclusions

Our preliminary results show that single-incision laparoscopic right colectomies are feasible and safe from the oncological point of view; nevertheless larger, randomized experiences are needed to demonstrate the benefits of SILS compared with standard laparoscopic resections.

This is a preview of subscription content, log in to check access.

Access options

Buy single article

Instant unlimited access to the full article PDF.

US$ 39.95

Price includes VAT for USA

References

  1. 1.

    Tong DK, Fan JK, Law WL (2008) Outcome of laparoscopic colorectal resection. Surgeon 6(6):357–360

  2. 2.

    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. J Cancer Treat Rev 34(6):498–504

  3. 3.

    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):439–446

  4. 4.

    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(9472):1718–1726

  5. 5.

    Rolanda C, Lima E, Pêgo JM, Henriques-Coelho T, Silva D, Moreira I, Macedo G, Carvalho JL, Correia-Pinto J (2007) Third-generation cholecystectomy by natural orifices: transgastric and transvesical combined approach (with video). Gastrointest Endosc 65(1):111–117

  6. 6.

    Gumbs AA, Fowler D, Milone L, Evanko JC, Ude AO, Stevens P, Bessler M (2009) Transvaginal natural orifice transluminal endoscopic surgery cholecystectomy: early evolution of the technique. Ann Surg 249(6):908–912

  7. 7.

    Binenbaum SJ, Teixeira JA, Forrester GJ, Harvey EJ, Afthinos J, Kim GJ, Koshy N, McGinty J, Belsley SJ, Todd GJ (2009) Single-incision laparoscopic cholecystectomy using a flexible endoscope. Arch Surg 144(8):734–738

  8. 8.

    Curcillo Ii PG, King SA, Podolsky ER, Rottman SJ (2009) Single port access (SPA) minimal access surgery through a single incision. Surg Technol Int 18:19–25

  9. 9.

    Romanelli JR, Earle DB (2009) Single-port laparoscopic surgery: an overview. Surg Endosc 23(7):1419–1427

  10. 10.

    Kim J, Edwards E, Bowne W, Castro A, Moon V, Gadangi P, Ferzli G (2007) Medial-to-lateral laparoscopic colon resection: a view beyond the learning curve. Surg Endosc 21(9):1503–1507

  11. 11.

    Cahill RA, Perretta S, Forgione A, Leroy J, Dallemagne B, Marescaux J (2009) Multimedia article. Combined sentinel node biopsy and localized sigmoid resection entirely by natural orifice transluminal endoscopic surgery: a new challenge to the old paradigm. Dis Colon Rectum 52(4):725

  12. 12.

    Dubcenco E, Grantcharov T, Streutker CJ, Rotstein OD, Baxter NN, Jeejeebhoy KN, Baker JP (2008) The development of a novel intracolonic occlusion balloon for transcolonic natural orifice transluminal endoscopic surgery: description of the technique and early experience in a porcine model (with videos). Gastrointest Endosc 68(4):760–766

  13. 13.

    Bucher P, Pugin F, Morel P (2008) Single port access laparoscopic right hemicolectomy. Int J Colorectal Dis 23(10):1013–1016

  14. 14.

    Remzi FH, Kirat HT, Kaouk JH, Geisler DP (2008) Single-port laparoscopy in colorectal surgery. Colorectal Dis 10(8):823–826

  15. 15.

    Merchant AM, Lin E (2009) Single-incision laparoscopic right hemicolectomy for a colon mass. Dis Colon Rectum 52(5):1021–1024

  16. 16.

    Rieger NA, Lam FF (2010) Single-incision laparoscopically assisted colectomy using standard laparoscopic instrumentation. Surg Endosc 24:888–890

  17. 17.

    Chambers W, Bicsak M, Lamparelli M, Dixon A (2009) Single-incision laparoscopic surgery (SILS) in complex colorectal surgery: a technique offering potential and not just cosmesis. Colorectal Dis doi:10.1111/j.1463-1318.2009.02158.x

Download references

Disclosures

Drs. Luigi Boni, Gianlorenzo Dionigi, Francesca Rovera, Matteo Di Giuseppe, Mario Diurni, Stefano Rausei, Fabrizio Cantore, and Renzo Dionigi have no conflicts of interest or financial ties to disclose.

Author information

Correspondence to Luigi Boni.

Electronic supplementary material

Below is the link to the electronic supplementary material.

Supplemental Digital Content 1. Video demonstrates the technique for single access laparoscopic right colectomy (WMV 21764 kb)

Supplemental Digital Content 1. Video demonstrates the technique for single access laparoscopic right colectomy (WMV 21764 kb)

Rights and permissions

Reprints and Permissions

About this article

Cite this article

Boni, L., Dionigi, G., Cassinotti, E. et al. Single incision laparoscopic right colectomy. Surg Endosc 24, 3233–3236 (2010). https://doi.org/10.1007/s00464-010-1100-4

Download citation

Keywords

  • Single-incision laparoscopic surgery
  • Right colectomy
  • Colorectal cancer