Laparoscopic Colectomy for Single Port Surgery in Colorectal Cancer. Initial Experiencia in Two Institucion in Colombia

Rafael garcia duperly, md, Fernando Arias amezquita, md, evelyn dorado, Md, eduardo londoño, md. fundacion santa fe bogota, clinica reina sofia

AIMS: show the initial experience in the management of patients with colon cancer with laparoscopic radical oncological with devices for single site surgery

TYPE DEVICE:we had two diferent types of devices for perform the surgery 1.  Alexis ( skin protector for applied medical) + glove 2.  SILS( covidien)
device: allows the realization of scarless surgery with good oncologic results 

In experienced hands laparoscopic colorectal surgery for malignant disease have similar oncologic outcomes to open surgery in patients with resectable colorectal cancer and rates of operative and perioperative morbility and mortality are comparable or lower. Laparoscopic colorectal surgery offers the advantages of a minimally invasive procedure (less pain, faster return of bowel function, fewer days of hospitalization). Once developed an expertise, a more recent technique, single port surgery (SP) is a further step in the development of laparoscopic surgery and can show similar results without sacrificing performance or operating time of traditional laparoscopic colorectal surgery, improving the requirement of analgesics and the risk of incisional hernias in the additional ports.

Methods: Retrospective analysis of laparoscopic right sided colorectal surgery performed by SP between 2009 and 2010, performed by the same group of colon and rectum surgeon in two institutions Clinic Fundation Santa Fe de Bogota and Reina Sofía in Bogota Colombia the demographic variables, complications, hospital stay and initiation of oral intake and patient condition were evaluated . 

Results: 32 patients, 17 right colectomy and 13 left colectomy. Promedium age: 62 year old.

We used two devices for the performance of the surgery: glove + alexis or sils .
Mean operative time was 122 minutes, average blood loss was 166 cc, theire were no patient converted to conventional open or laparoscopic surgery for multiple ports. The intra and postoperative complications were: bleeding in a patient from the anastomosis requiring transfusion of 2 units of red blood cells, colonoscopy and control of the vessel, one incisional hernia and two abscesses, the average time of onset of the oral intake was 21 hours, average hospital stay was 5 days, and there was 1 readmission within 30 days by a thrombosis of the superior mesenteric vein.

The single port procedures require advanced laparoscopic techniques, trained staff and high tech institutions. We want to show our initial experience with laparoscopic surgery for single port equivalent oncologic outcomes to open surgery with little morbidity and excellent cosmesis and benefits like: less pain, quick recovery and early start of activities. we are the first group in Colombia to perform this technique with excellent results.

Session: Emerging Technology Poster
Program Number: ETP004
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