Single incision laparoscopic colectomy (SILC), like single incision surgery in other specialities, has developed in a continuing quest to decrease the points of abdominal access of laparoscopic surgery. Decreased number of trocar sites likely correlates with less trauma to the abdominal wall, and therefore less postoperative pain for the patient compared to multiport laparoscopic colectomy (MPLC). It may also correlate with shorter length of postoperative stay. In SILC, all laparoscopic instruments are inserted through one incision, most commonly at the umbilicus, to perform the operation. Usually an access device is used to place all trocars through one fascial incision. Right-sided procedures are especially amenable to the technique given the relatively focused colonic target, fewer operative steps and the option to perform an exterior anastomosis. Appendectomy, extended appendectomy or partial cecetomy and right hemicolectomy are excellent initial cases when adopting the SILC technique.
Laparoscopic colectomy is technically complex and requires advanced surgical skills. Surgeons who are proficient in MPLC are appropriate to approach SILC in their practice.
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