First Single-Port Laparoscopic Pancreatectomy in Brazil

Machado, Marcel Autran; Surjan, Rodrigo C.; Makdissi, Fábio F.

doi:10.1590/s0004-28032013000400013

Cited by 5 publications

(5 citation statements)

References 12 publications

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“…Recently, three more cases were performed in our department. Now, during the 29 cases, transumbilical single-incision laparoscopy spleen-preserving distal pancreatectomy in 16 cases and single-incision laparoscopy distal pancreatectomy without splenic preservation in 13 case were performed, and the patients’ postoperative recoveries were all uneventful [ 6 – 13 ]. Now, these experiences well confirm the feasibility and safety of the TUSI-LDP in selected cases.…”

Section: Discussionmentioning

confidence: 99%

“…Recently, for further minimizing surgical trauma by reducing the number of the port, many experienced laparoscopic surgeons have tried to develop a new minimally invasive technique called “single incision laparoscopic surgery” (SILS), which has been now successfully and widely applied in many fields of abdominal surgery [ 4 , 5 ]. However, The SILS performed on the pancreatic lesions has been reported only recently, and the experience is still limited now [ 6 – 13 ]. Therefore, more studies are still required to confirm the feasibility of transumbilical single-incision laparoscopic distal pancreatectomy (TUSI-LDP).…”

Section: Introductionmentioning

confidence: 99%

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Transumbilical single-incision laparoscopic distal pancreatectomy: preliminary experience and comparison to conventional multi-port laparoscopic surgery

Yao

et al. 2014

BMC Surg

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BackgroundSingle-incision laparoscopic surgery (SILS), which has been demonstrated to be safely applied on kinds of surgeries, may represent an improvement over conventional multi-port laparoscopic surgery. However, there are still few clinical experiences of SILS in pancreatic surgery until now. In this study, we will summarize our experience of transumbilical single-incision laparoscopic distal pancreatectomy (TUSI-LDP), and compare its related parameters with conventional multi-port laparoscopic distal pancreatectomy (C-LDP).MethodsA retrospective analysis was conducted for the patients who underwent C-LDP or TUSI-LDP in our department. The demographic data, operative parameters, and postoperative complications in the two groups were summarized and compared.ResultsLaparoscopic distal pancreatectomy was performed in a total of 21 cases, among which TUSI-LDP was performed in 14 cases. As far as the demographical results concerned, there were no significant differences between the two groups. The conversion to open surgery was conducted in one case in the TUSI-LDP group because of severe adhesion between pancreatic cyst and surrounding tissues, while in the C-LDP group the only one conversion was for the difficult detection of small lesion. The mean operating time and intraoperative blood loss in TUSI-LDP group was a little shorter (166.4 ± 57.4 versus 202.1 ± 122.5 minutes, p > 0.05, and 157.1 ± 162.4 versus 168.6 ± 157.4 ml, p > 0.05). The postoperative pain and post-operation lengths of hospital stay in the TUSI-LDP group were also less, though there was no significant statistical difference between the two groups. For the post-operation complications, in TUSI-LDP group the pancreatic leakage occurred in only one case, and ceased spontaneously with only a drain for 61 days. There were no other complications including postoperative hemorrhage, venous thrombosis, infections and so on in both groups.ConclusionFor the experienced laparoscopic surgeons, in selected patients, TUSI-LDP is a feasible technique, with excellent cosmetic effect, less postoperative pain and post-operation lengths of hospital stay. With the experience accumulated, the operating time and intraoperative blood loss of TUSI-LDP could also gradually reduce.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Transumbilical single-incision laparoscopic distal pancreatectomy: preliminary experience and comparison to conventional multi-port laparoscopic surgery

Yao

et al. 2014

BMC Surg

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“…It is especially used in young female due to the good cosmetic results. Single-incision laparoscopic procedure is less invasive than standard multiport laparoscopy but may have unique difficulties for the laparoscopic surgeon 12 , 13 . First, retraction is significantly limited.…”

Section: Discussionmentioning

confidence: 99%

“…In the last few years, a novel technique with a single-incision laparoscopic approach has been described 3 . This technique has mainly been used for laparoscopic cholecystectomy, but recent reports showed feasibility even in more complex operations such as gastric, liver and pancreas resection 12 , 13 , 19 .…”

Section: Introductionmentioning

confidence: 99%

Single-port for laparoscopic gastric resection with a novel platform

Machado

Makdissi

Surjan

2014

ABCD, arq. bras. cir. dig.

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IntroductionLaparoscopic gastrointestinal resections using single-port are possible, but triangulation problems and the need of articulated instruments difficult the procedures.AimTo present a surgical alternative using single-port laparoscopic device on gastric resection.TechniqueThe patient is placed in a supine and reverse Trendelenburg position with surgeon between patient's legs. First assistant was on the right side of the patient with the monitor placed on the patient's cranial side. With the patient under general anesthesia, a transumbilical 3 cm skin incision is performed. A single-incision advanced access platform with gelatin cap, self-retaining sleeve and wound protector is introduced through this incision. Three 5-12 mm operating ports were introduced through the single-port device. Due to the gel cap and sleeves, no articulated instruments are necessary. CO2 pneumoperitoneum is established at 12 mmHg. A rigid 30 degree 10 mm laparoscope is introduced. Operation begins with access to the lesser sac by opening the omentum along the greater curvature of the stomach using harmonic scalpel. Once the stomach is fully exposed and a stay suture is place around the tumor. Gastric wall is divided with cautery 1 cm away from the tumor. Tumor is excised. Gastric wall is sutured with two-layer running suture. No drain was used. Umbilical incision was closed.ResultsThis procedure was used in one patient with gastric duplication. Operative time was 200 minutes. Blood loss was minimal. Recovery was uneventful and patient discharged on postoperative day 2. Final aspect of the umbilical incision was good.ConclusionsGastric resection with single-port laparoscopic platform is feasible and may be safely performed in selected patients.

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“…However, it is interesting to note that a spleenpreserving procedure was performed even in 46 patients (78%). A summary of perioperative outcomes showed that 20 patients were male, and 37 were female with a mean age of 45.9 ±16.0 years (gender information was missing in one report 13 ). Most pathologic diagnoses were benign or borderline malignant tumors of the pancreas with a mean tumor diameter of 3.4±1.6 cm.…”

Section: Currently Available Surgical Platforms and Short-term Outcomesmentioning

confidence: 99%

Minimally Invasive (Laparoscopic or Robotic) Reduced Port (Single Port) Distal Pancreatectomy

Kang

2017

J Minim Invasive Surg

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In spite of lack of randomized control study, laparoscopic distal pancreatectomy (DP) is regarded as appropriate treatment in managing benign and low grade malignant tumor in distal part of the pancreas. With the advance of laparoscopic skills, innovative instruments, and perioperative management, clinical effort to reduce the access injury for laparoscopic DP has been attempted to enhance the cosmetic effect and the benefit of minimally invasive surgery. Due to inborn technical limitation of laparoscopic surgical system, it is not easy to perform laparoscopic reduced port-or single port-distal pancreatectomy (LRP/LSP-DP) in daily routine clinical practice, however, surgical technique for safe and effective LRP/LSP-DP has been developed. Till now, only a few experts reported the technical feasibility and safety of LRP/LSP-DP in selected patients. According to literature review, the number of the patients who underwent LRP/LSP-DP seems to gradually increase. In this moment, surgical experiences may be too limited to reach the conclusion, but, with the help of robotic surgical system, LRP/LSP-DP has potential room for further investigation. Therefore, minimally invasive surgeons need to pay attention to this innovative movement. In this review, currently available surgical techniques for LRP/LSP-DP has been summarized with some future perspectives on this technique.

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First Single-Port Laparoscopic Pancreatectomy in Brazil

Cited by 5 publications

References 12 publications

Transumbilical single-incision laparoscopic distal pancreatectomy: preliminary experience and comparison to conventional multi-port laparoscopic surgery

Transumbilical single-incision laparoscopic distal pancreatectomy: preliminary experience and comparison to conventional multi-port laparoscopic surgery

Single-port for laparoscopic gastric resection with a novel platform

Minimally Invasive (Laparoscopic or Robotic) Reduced Port (Single Port) Distal Pancreatectomy

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