Abstract
Background
Laparoscopic sigmoidectomy has become the standard procedure in elective surgery for recurrent diverticular disease. To realize further benefits of this minimal invasive procedure and to offer less postoperative pain, shorter recovery time, reduced complications, and improved cosmetic results, attempts are being made to minimize the number of necessary skin incisions for trocar positioning. One method is to use only one port for laparoscopic access to perform diverticular-related elective sigmoidectomies.
Methods
Between 7 July and 4 August 2009, 10 consecutive patients were referred for partial left colon resection due to multiple episodes of diverticulitis. In all cases, access to the abdomen was achieved through a 2- to 2.5-cm single incision via the umbilicus followed by insertion of the single-incision laparoscopic surgery (SILS™) port system. Outcomes such as change in the procedural method, operative time, postoperative complications, and length of stay were recorded.
Results
Of the 10 consecutive sigmoidectomies, 9 were performed successfully with the SILS™ procedure using only one incision in the umbilicus. No mortalities or major complications were noted. The median operating time was 120 min, and the median postoperative hospital stay was 7 days.
Conclusion
As an alternative to the standard laparoscopic procedure, single-incision laparoscopic sigmoidectomy via the umbilicus is technically feasible and effective. This attractive procedure aims to increase the patient’s comfort further after abdominal surgery.
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References
Marohn MR, Hanly EJ, Mc Kenna KJ, Varin CR (2005) Laparoscopic total abdominal colectomy in the acute setting. J Gastrointest Surg 9:881–886
Rosman AS, Melis M, Fichera A (2005) Metaanalysis of trials comparing laparoscopic and open surgery for Crohn’s disease. Surg Endosc 19:1549–1555
Tacchino R, Greco F, Matera D (2009) Single-incision laparoscopic cholecystectomy: surgery without a visible scar. Surg Endosc 23:896–899
Ersin S, Firat O, Sozbilen M (2009) Single-incision laparoscopic cholecystectomy: is it more than a challenge? Surg Endosc. doi:10.1007/s00464-009-0543-y
Nguyen NT, Reavis KM, Hinojosa MW, Smith BR, Stamos MJ (2009) A single-port technique for laparoscopic extended stapled appendectomy. Surg Innov 16:78–81
Reavis KM, Hinojosa MW, Smith BR, Nguyen NT (2008) Obes Surg 18:1492–1494
Gonzales JJ (2009) Sleeve gastrectomy and the SILS™ procedure: The Texas Endosurgery Institute Experience. Bariatric Times 6((Suppl2)):6–7
Remzi FH, Kirat HAT, Kaouk JH, Geisler DP (2008) Single-port laparoscopy in colorectal surgery. Colorectal Dis 10:823–826
Bucher P, Pugin F, Morel P (2008) Single-port-access laparoscopic right hemicolectomy. Int J Colorectal Dis 23:1013–1016
Leroy J, Cahill RA, Peretta S, Marescaux J (2008) Single-port sigmoidectomy in an experimental model with survival. Surg Innov 15:260–265
Leroy J, Cahill RA, Asakuma M, Dallemagne B, Marescaux J (2009) Single-access laparoscopic sigmoidectomy as definitive surgical management of prior diverticulitis in a human patient. Arch Surg 144:173–179
Brunner W, Schirnhofer J, Waldstein-Wartenberg N, Frass R, Pimpl K, Weiss H (2009) New: single-incision transumbilical laproscopic surgery. Eur Surg 41:98–103
Franklin ME Jr, Ramos P, Rosenthal D, Schuessler W (1993) Laparoscopic colonic procedures. World J Surg 17:51–56
Jones OM, Stevenson ARL, Clark D, Stitz RW, Lumley JW (2008) Laparoscopic resection for diverticular disease. Ann Surg 248:1092–1097
Ponsky JL, Rosen MJ, Poulose BK (2008) NOTES: of caution. Surg Endosc 22:1561–1562
Chamberlain RS, Sakpal SV (2009) A comprehensive review of single-incision laparoscopic surgery (SILS) and natural orifice transluminal endoscopic surgery (NOTES) techniques for cholecystectomy. J Gastrointest Surg 13:1733–1740
Nguyen NT, Reavis KM, Hinojosa MW, Smith BR, Wilson SE (2009) Laparoscopic transumbilical cholecystectomy without visible abdominal scars. J Gastrointest Surg 13:1125–1128
Hodgett SE, Hernandez JM, Morton CA, Ross SB, Albrink M, Rosemurgy AS (2009) Laparoendoscopic single-site (LESS) cholecystectomy. J Gastrointest Surg 13:188–192
Disclosures
Boris Vestweber and Claudia Paul received lecturing fees from Covidien. Boris Vestweber, Angelika Alfes, Claudia Paul, and Franz Haaf received travel grants from Covidien. Karl-Heinz Vestweber and Franz Haaf received travel grants from Ethicon Endo-Surgery. Angelika Alfes received travel grants from Storz.
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Vestweber, B., Alfes, A., Paul, C. et al. Single-incision laparoscopic surgery: a promising approach to sigmoidectomy for diverticular disease. Surg Endosc 24, 3225–3228 (2010). https://doi.org/10.1007/s00464-010-1090-2
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DOI: https://doi.org/10.1007/s00464-010-1090-2