Hanako Nakasaki, Shinichiro Mori, Yoshiaki Kita, Kenji Baba, Kan Tanabe, Masayukie Yanagi, Takaaki Arigami, Yasuto Uchikado, Kosei Maemura, Masahiko Sakoda, Shoji Natsugoe. Department of Digestive, Breast and Thyroid Surgery, Graduate School of Medicine, Kagoshima University
Devise: Endo Relief (Hope Denshi, Kamagaya, Chiba, Japan)
Objective: We have evaluated the safety and feasibility of laparoscopic complete mesocolic excision (CME) via reduced port surgery (RPS) using Endo Relief for colon cancer.
Methods: We prospectively assessed 17 consecutive patients with colon cancer underwent laparoscopic CME via RPS using Endo Relief between February 2012 and January 2014. Video recordings were used to assess the quality of CME. We also assessed operative data, complications, pathological findings, visual analog scale (VAS), cosmesis and the hospital length of stay.
Surgical procedure: The skin was cut approximately 4 cm in diameter in the umbilical region, and an access devise was inserted. Three mm trocar for the left hand and 5-mm trocar for the right hand of the operator were positioned under laparoscopic guidance. Then Endo Relief with a 2.4-mm shaft and a head 5 mm in diameter was introduced for a 3-mm trocar. Laparoscopic instruments were inserted and a medial to lateral approach used for right colon cancer. After mobirizing ascending colon including lymph nodes dissection, the resultant specimens were easily extracted from the abdomen through the umbilical incision, after which extracorporeal functional end-to-end anastomosis was performed using linear staplers.
Results: All patients underwent en bloc resection of mesocolon with CME completion. The median surgical duration and blood loss were 298 min and 41 mL, respectively. No intraoperative complications occurred in any patient. The median number of lymph nodes retrieved was 20, lymph node metastasis being identified in eight patients. The mean VAS scores for postoperative days 1, 3 and 7 were 3.2, 1.5 and 0, respectively. All patients were satisfied with their cosmesis. The median postoperative hospital stay was 11 days.
Conclusions Laparoscopic CME via RPS using Endo Relief for colon cancer is a safe and feasible surgical procedure with cosmetic advantages.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 91265
Program Number: ETP841
Presentation Session: Emerging Technology iPoster Session (Non CME)
Presentation Type: Poster