Single-port colonic surgery

Abstract

Colonic surgery is feasible with the single-port technique using standard laparoscopic instruments. Operative time and complication rates are comparable to conventional standard laparoscopic procedures. Position of instruments (crossed over) and orientation are somewhat different and need to be trained and practiced. In this patient collective 200 colon resections covering the complete spectrum of colonic surgery were done in our department. Of these 120 patients were operated on because of sigma diverticulitis. The average operative time was 149 min whereby 6 patients (5.0%) had to be converted to an open procedure, 12 (10.0%) patients had early complications, of which 6 (5.0%) had minor wound complications which were treated conservatively and 4 (3.3%) patients had late complications (2 stenoses and 2 hernias) during the mean follow-up time of 7.5 months (range 6-14 months). The cosmetic effect was very good and functional results were good. Single-port colon operations are the least invasive procedure available at the moment.

Evaluation of Current Devices in Single‐Incision Laparoscopic Colorectal Surgery

“…Meanwhile, we reported on 200 colonic single‐port procedures, including 120 sigmoidectomies/anterior rectum resections, 10 subtotal colectomies, 7 proctocolectomies with ileum pouch, 12 anterior rectum resections because of malignant disease, 7 abdominoperineal resections, and 3 left hemicolectomies; right‐sided resections counted for 26 procedures [3].…”

“…We use the SILS™ port (Covidien, Germany) and only standard laparoscopic instruments, including a long 5‐mm 50‐cm 30° optic (Storz, Germany). Several experienced conventional laparoscopic surgeons of our team showed no significant learning curve according to operative time with the left‐sided SILS procedures, such as sigmoidectomies/anterior rectum resections [3].…”

Evaluation of Current Devices in Single‐Incision Laparoscopic Colorectal Surgery: A Preliminary Experience in 32 Consecutive Cases: Reply

“…We thank Vestweber et al [1] for their interest in our article [2]. We embarked on single‐incision laparoscopic surgery (SILS) anterior resections (AR) with great interest as did many surgeons around the world and the article was a report of our initial results and learning curve.…”

“…We are hesitant to extend the use of SILS for all indications of surgery as we feel there are still technical limitations. We congratulate the Vestweber [4] group on reporting their outcome on their large number of single-port patients and look forward to learning about their technical developments. We also await further data from our colleagues worldwide.…”