Experience of Single-incision Laparoscopic Surgery for the Small Intestine Lesion

Shingo Ito, Kazuhiro Sakamoto, Yuichi Tomiki, Atsushi Okuzawa, Michitoshi Goto, Yutaka Kojima, Hiromitsu Komiyama, Makoto Takahashi, Yukihiro Yaginuma, Shun Ishiyama, Kiichi Sugimoto, Masaya Kawai, Kazuhiro Takehara, Shinya Munakata, Hisashi Ro, Kosuke Mizukoshi, Jun Aoki, Yuu Okazawa, Rina Takahashi, Kumpei Honjo, Ryousuke Ichikawa, Kazumasa Kure. Department of Coloproctological Surgery, Faculty of Medicine, Juntendo University.

INTRODUCTION – In late years,the laparoscopic surgery spreads out rapidly, and Single-Incision Laparoscopic Surgery for the small intestine disease is thought about with good adaptation above all. We examine safety and usefulness of the Single-Incision Laparoscopic Surgery for the small intestine lesion.

METHODS AND PROCEDURES – Single-Incision Laparoscopic Surgery for small intestine lesions was performed in six patients between July 2009 and July 2013. Perioperative data and short-term outcomes were assessed.

RESULTS – The diagnoses included small intestine cancer, carcinoid, malignant lymphoma, granulomatous inflammation, small intestine ulcer and Meckel’s diverticulum in one patient each. Five patients, except one patient diagnosed as inflammatory granuloma pathologically, were undergone small intestine endoscopy and preoperatively diagnosed by the endoscopic biopsy and made a tattoo marking at the small intestinal lesion. We put the incision of 2~5cm long to the umbilical region, and the approach in the abdominal cavity inserts a port in all cases. As platforms, the E.Z accessTM, was used in three patients and glove method was used in three patients, and a rigid 10mm laparoscope was used in all patients. A segmental resection of the small intestine was performed in all patients, and the mean operative time was two hours 17 minutes. The quantity of operative blood loss was 30ml and the mean postoperative hospital stay was 11 days. In addition, there was no postoperative complication.

CONCLUSION – Single-Incision Laparoscopic Surgery for the small intestine lesion was not only superior cosmetically, and it was thought that it was safe, useful method.

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