Single-Port Laparoscopic TME with Coloanal Anastomosis

  • Armando Geraldo Franchini Melani
  • Luis Gustavo Capochin Romagnolo
  • Frédéric Bretagnol


Minimally invasive surgery is one of the major technical advances of the past 20 years. Interest in laparoscopy has led to the development of more minimally invasive surgeries such as natural orifice transluminal endoscopic surgery (NOTES) and laparoendoscopic single-site surgery (LESS).

The laparoendoscopic single-site surgery (LESS) emerged with the potential benefit of a single incision associated with the advantages of the laparoscopy to perform colorectal procedures. LESS is an emerging technique that meets enthusiastic surgical community, as stated by the large and increasing number of publications within the last years. The challenge to perform LESS is the triangulation needed among the instruments using a single-incision access. Compared with conventional laparoscopy using multiport access, the LESS approach may be more difficult to provide a good exposure of the surgical field. But in addition to the benefits of laparoscopy, LESS may offer a reduction in port-related complications such as pain, faster postoperative recovery, and improved cosmesis. The aim of this chapter is to describe the single-port technique to do total mesorectal excision (TME) resection with coloanal anastomoses.


Laparoscopy Laparoendoscopy Rectal cancer 


  1. 1.
    Leroy J, Jamali F, Forbes L, Smith M, Rubino F, Mutter D, et al. Laparoscopic total mesorectal excision (TME) for rectal cancer surgery: long-term outcomes. Surg Endosc. 2004;18(2):281–9.CrossRefPubMedGoogle Scholar
  2. 2.
    Maeda K, Noda E, Nagahara H, Inoe T, Takii M, Watanabe K, et al. A comparative study of single-incision versus conventional multiport laparoscopic ileocecal resection for Crohn’s disease with strictures. Asian J Endosc Surg. 2012;5(3):118–22.CrossRefPubMedGoogle Scholar
  3. 3.
    Choi B, Lee S, Kang W. Single-port laparoscopic total mesorectal excision with transanal resection (transabdominal transanal resection) for low rectal cancer: initial experience with 22 cases. Int J Surg. 2013;11(9):858–63.CrossRefPubMedGoogle Scholar
  4. 4.
    Tokuoka M, Ide Y, Taleda M, Hashimoto Y, Matsuyama J, Yokoyama S, et al. Single-incision plus one port laparoscopic total mesorectal excision and bilateral pelvic node dissection for advanced rectal cancer - a medial umbilical ligament approach. Int Surg. 2015;100(3):417–22.CrossRefPubMedPubMedCentralGoogle Scholar
  5. 5.
    Kim F, Chammas M, Gewehr E, Morihisa M, Caldas F, Hayacibara E. Temperature safety profile of laparoscopic devices: harmonic ACE (ACE), Ligasure V (LV), and plasma trisector (PT). Surg Endosc. 2008;22(6):1464–9.CrossRefPubMedGoogle Scholar
  6. 6.
    Remzi FH, Kirat HT, Kaouk JH, Geisler DP. Single-port laparoscopy in colorectal surgery. Color Dis. 2008;10(8):823–6.CrossRefGoogle Scholar
  7. 7.
    Leroy J, Cahill RA, Asakuma M, Dallemagne B, Marescaux J. Single-access laparoscopic sigmoidectomy as definitive surgical management of prior diverticulitis in a human patient. Arch Surg. 2009;144(2):173–9. discussion 9CrossRefPubMedGoogle Scholar
  8. 8.
    Merchant AM, Lin E. Single-incision laparoscopic right hemicolectomy for a colon mass. Dis Colon rectum. 2009;52(5):1021–4.Google Scholar
  9. 9.
    Bucher P, Pugin F, Morel P. Transumbilical single incision laparoscopic sigmoidectomy for benign disease. Color Dis. 2010;12(1):61–5.CrossRefGoogle Scholar
  10. 10.
    Geisler DP, Condon ET, Remzi FH. Single incision laparoscopic total proctocolectomy with ileopouch anal anastomosis. Color Dis. 2010;12(9):941–3.CrossRefGoogle Scholar
  11. 11.
    Law WL, Fan JK, Poon JT. Single incision laparoscopic left colectomy for carcinoma of distal transverse colon. Color Dis. 2010;12(7):698–701.CrossRefGoogle Scholar
  12. 12.
    Rieger NA, Lam FF. Single-incision laparoscopically assisted colectomy using standard laparoscopic instrumentation. Surg Endosc. 2010;24(4):888–90.CrossRefPubMedGoogle Scholar
  13. 13.
    Lee PC, Lo C, Lai PS, Chang JJ, Huang SJ, Lin MT, et al. Randomized clinical trial of single-incision laparoscopic cholecystectomy versus minilaparoscopic cholecystectomy. Br J Surg. 2010;97(7):1007–12.CrossRefPubMedGoogle Scholar
  14. 14.
    Chow A, Purkayastha S, Nehme J, Darzi LA, Paraskeva P. Single incision laparoscopic surgery for appendicectomy: a retrospective comparative analysis. Surg Endosc. 2010;24(10):2567–74.CrossRefPubMedGoogle Scholar
  15. 15.
    Raman JD, Bagrodia A, Cadeddu JA. Single-incision, umbilical laparoscopic versus conventional laparoscopic nephrectomy: a comparison of perioperative outcomes and short-term measures of convalescence. Eur Urol. 2009;55(5):1198–204.CrossRefPubMedGoogle Scholar
  16. 16.
    Maggiori L, Gaujoux S, Tribillon E, Bretagnol F, Panis Y. Single-incision laparoscopy for colorectal resection: a systematic review and meta-analysis of more than a thousand procedures. Color Dis. 2012;14(10):e643–54.CrossRefGoogle Scholar
  17. 17.
    Fung AK, Aly EH. Systematic review of single-incision laparoscopic colonic surgery. Br J Surg. 2012;99(10):1353–64.CrossRefPubMedGoogle Scholar
  18. 18.
    Gill IS, Advincula AP, Aron M, Caddedu J, Canes D, Curcillo PG 2nd, et al. Consensus statement of the consortium for laparoendoscopic single-site surgery. Surg Endosc. 2010;24(4):762–8.CrossRefPubMedGoogle Scholar
  19. 19.
    Poon JT, Cheung CW, Fan JK, Lo OS, Law WL. Single-incision versus conventional laparoscopic colectomy for colonic neoplasm: a randomized, controlled trial. Surg Endosc. 2012;26(10):2729–34.CrossRefPubMedGoogle Scholar
  20. 20.
    Huscher CG, Mingoli A, Sgarzini G, Mereu A, Binda B, Brachini G, et al. Standard laparoscopic versus single-incision laparoscopic colectomy for cancer: early results of a randomized prospective study. Am J Surg. 2012;204(1):115–20.CrossRefPubMedGoogle Scholar

Copyright information

© Springer Japan 2018

Authors and Affiliations

  • Armando Geraldo Franchini Melani
    • 1
    • 2
  • Luis Gustavo Capochin Romagnolo
    • 3
  • Frédéric Bretagnol
    • 4
  1. 1.Colorectal Oncology Surgery, Americas Medical CityRio de JaneiroBrazil
  2. 2.IRCADRio de JaneiroBrazil
  3. 3.Department of Colorectal SurgeryBarretosBrazil
  4. 4.Department of Digestive SurgeryHôpital Louis Mourier (APHP)ColombesFrance

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