Laparoscopic colorectal surgery using reduced port surgery device (EZ Access TM)

Kazuki Ueda, MD, Junichiro Kawamura, MD, Koji Daito, MD, Fumiaki Sugiura, MD, Yasumasa Yoshioka, MD, Yoshinori Yane, MD, Jin-ichi Hida, MD, Haruhiko Imamoto, MD, Kiyotaka Okuno, MD. Kindai University Faculty of Medicine

Introduction Our division started laparoscopic surgery for colorectal cancer (LAC) in 1995. Over 500 cases of LAC have experienced until the end of 2014. Our current distinctive technique of LAC is using reduced port surgery devices named EZ Access^TM with LAP PROTECTOR^TM mini (Hakko Co. Ltd., Tokyo, Japan) as shown in the picture. This presentation will show our technique and present the advantages using EZ Access with LAP PROTECTOR mini.

Method Approximately 3.5-cm umbilical incision is created and placed the EZ Access with LAP PROTECTOR mini in this incision when starting LAC. Two trocars (12-mm and 5-mm) are placed in the EZ Access.  An adequate number of trocar is placed for the procedure (usually 3 or 4 trocars). Open procedure and the extraction of the specimen are done through the LAP PROTECTOR mini (just unfixed the EZ Access).

Results Peri- and post-operative outcomes were equivalent to our method compared to conventional LAC. Especially, surgical site infection was quite low incidence. There are several advantages including; (1) Freeing of adhesion around umbilicus is easy to do under direct vision. (2) Re-pneumoperitoneum is simple just putting on the EZ Access. (3) This method can respond immediately to incidental hemorrhage or bowel injury.

Conclusion The EZ Access^TM with LAP PROTECTOR mini^TM is useful device to perform LAC.