Single-port Laparoscopic Colorectal Surgery Experience

Rafael Garcia, MD, Anwar Medellin, MD, Maria Isabel, MD, Eduardo Londono, MD, Javier Carrera, MD, Fernando Arias, MD. Hospital Universitario Fundacion Santa Fe de Bogota

INTRODUCTION: The number of single-port laparoscopic procedures had been growing in recent years, increasing with it the number of diseases that can be treated by this approach. Colorectal surgery is a good example of this discipline and can offer an appropriate management of benign and malignant diseases.

OBJECTIVE: Our aim is to show experience accumulated by the Colorectal Surgery Group in Single-Port Laparoscopic in Fundación Santafe de Bogota in all the patients with both benign and malignant diseases treated with this approach. Also, we want to describe the demographic characteristics of these patients, and identify the results and outcomes of this procedure.

MATERIAL AND METHODS: It is a retrospective evaluation of all patients that underwent single port laparoscopic colorectal surgery, between January 2009 and December 2013, including patients with both benign and malignant disease and those who required conversions. Outcomes are identified and analyzed.

RESULTS: 103 patients underwent single-port laparoscopic surgery during specified dates. The mean numbers of surgery per years was 20. The mean age of the patients was 61 years and the majority were women (59%). 35% of patients had previous abdominal surgery. The more frequent procedure was right hemicolectomy in 68.9%. 70% of patients were operated for malignant disease, with most of them being T3 and T4 cases (73%). Right colon cancer was the most common pathology in 36% of cases and the most common histopathology report was moderately differentiated adenocarcinoma (36.9 %). The most common benign disease was diverticular disease in 10.7%. The mean operative time, was 117 minutes. The estimated blood loss was 92 cc. Only 6.7% patients required conversion, two of them were converted to one accessory port, two to conventional multiport laparoscopic surgery, and three to open surgery.

The length stay was 4.7 days. Postoperative complications were 4.8% patients had ileus, two% patients had wound infection. The only reported mortality was for pulmonary embolism.

CONCLUSION: In our experience, single port laparoscopic colorectal surgery can be performed with similar results compared to conventional multiport laparoscopic surgery, arguably with the benefits of this approach. Our results were similar to those reported in the literature. It requires a careful selection of patients and extensive experience in laparoscopic surgery. Further studies with larger series are needed to establish more benefits of this approach over conventional laparoscopic surgery.

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