Single-incision laparoscopically assisted colectomy using standard laparoscopic instrumentation

Abstract

A prospective case series of transumbilical single-incision laparoscopic colectomies using conventional laparoscopic trocars and instruments is described. Seven selected patients with colonic neoplasm underwent transumbilical SIL colectomy between November 2008 and March 2009. Three trocars via a single small umbilical incision were used. The bowel was mobilized and the vessels ligated intracorporeally with an extracorporeal anastomosis. This series of seven patients (6 men and 1 woman) had no conversion to standard multiport laparoscopy or open surgery. Six of the patients had pathology in the right colon, and one had a carcinoma at the splenic flexure. The patients had an average age of 71 years (range, 63–83 years) and an average body mass index (BMI) of 24.3 kg/m² (range, 21–28 kg/m²). The average operating time was 89 min (range, 75–115 min). No significant blood loss or complications occurred. The average length of hospital stay was 5.4 days (range, 4–11 days). The average incision length was 3.1 cm (range, 2.5–4.5 cm). Histopathology showed adequate tumor excision margins and an average lymph node yield of 15 nodes (range, 7–26 nodes). Single-incision laparoscopic surgery for colectomy is feasible. It can be performed without specialized instrumentation and at no extra cost. Further evaluation is required.