Author's reply: Single-incision laparoscopic right hemicolectomy (Br J Surg 2010; 97: 1881–1883)

Abstract

The Editors welcome topical correspondence from readers relating to articles published in the Journal. Responses should be sent electronically via the BJS website (www.bjs.co.uk). All letters will be reviewed and, if approved, appear on the website. A selection of these will be edited and published in the Journal. Letters must be no more than 250 words in length. Single-incision laparoscopic right hemicolectomy (Br J Surg 2010; 97: 1881-1883) SirAs advocates of single-incision laparoscopic surgery (SILS) we were interested in the paper by Keshava and colleagues describing the feasibility of SILS right hemicolectomy. The major advantage of SILS surgery as far as we are concerned is cosmesis, with effectively 'scarless' surgery owing to the wound being hidden within the umbilicus. The stated risks of abdominal wall and internal organ trauma, as well as port-site herniation, with two extra 5mm trocars placed to aid dissection are negligible.The median size of the midline laparotomy wound was 4 (range 3-6) cm and extended outside the borders of the umbilicus (Fig. 2). The cosmetic benefits of this method are therefore no different from those of the standard laparoscopic approach, barring two 5-mm incisions.Because of the size of the right hemicolectomy resection specimen it may not be possible to perform SILS surgery with the wound inside the umbilicus and therefore without external visible scarring. As the insertion of extra dissection ports would make the surgery quicker and easier, the value of a single-incision approach in this operation, although feasible, would have to be questioned.