Single-Port Laparoscopic Right Hemicolectomy: A Safe Alternative to Conventional Laparoscopy

Abstract

These findings support single-port right colectomy as a safe and efficacious approach to right colon resections in patients eligible for laparoscopy with minimal additional equipment or learning curve for experienced laparoscopic colorectal surgeons. The single port was undertaken without an increase in morbidity or mortality. There was no increase in operative time with use of the single-port approach. Finally, adequate lymph node harvest and margin clearance was maintained.

Rational Manipulation of the Standard Laparoscopic Instruments for Single-Incision Laparoscopic Right Colectomy

“…We use the SILS Access Port for right colectomy because it is a flexible laparoscopic port that can accommodate up to 3 instruments, and because its simplicity allows it to maintain adequate pneumoperitoneum. 6,9 The limitations of this port are hand collisions externally and difficulty with instrument tip manipulation internally. 6 To avoid internal conflict of instruments, a cross-handed approach using curved laparoscopic instruments has been established.…”

Single – Incision Laparoscopic Surgery for Rectal Cancer

“…Another expected advantage of a small incision is the reduction of postoperative pain. None of the published reports assessed the postoperative pain or analgesic requirements (32)(33)(34)(35). Technical difficulties of single-access as the lack of triangulation and exposure, the inaxis view and conflicts between instruments are the most important challenges.…”

Evaluation of the results of unique laparoscopic access surgery versus standard laparoscopic interventions for colorectal cancer

“…Нередко специалисты воздерживаются от лапа-роскопических оперативных вмешательств у больных с ожирением [23]. Некоторые хирурги в качестве противо-показания к применению SILS-технологии рассматрива-ют осложнения опухолевого процесса, стадию T4 опухоли и ранее выполнявшиеся открытые операции на органах брюшной полости [24,25]. В целом при сравнении едино-го лапароскопического доступа и стандартной лапароско-пической технологии у больных с опухолью ободочной и прямой кишки не выявлено достоверных различий в бли-жайших и отдаленных результатах [18], а также в стоимо-сти лечения [26,27].…”