Short term results of double incision laparoscopic right colectomy

Yoshinori Imai, Shinsuke Kajiwara, Hidenori Kiyochi, Kenzo Okada, Toshihiko Sakao, Taro Nakamura, Naoki Ishida, Tetsuya Mizumoto, Masaru Matsumura, Michiko Yamashita, Tatsuo Yamauchi, Tomoaki Okada, Yusuke Nakagawa, Yoshitomo Ueno

Uwajima City Hospital

Introduction: Single-incision laparoscopic surgery (SILS) is a minimally invasive technique recently applied to colorectal surgery. However, the SILS technique is difficult, and the surgical safety and the accuracy of lymph node dissection still remain controversial in comparison to conventional multiport surgery. A new hybrid laparoscopic procedure, double incision laparoscopic surgery (DILS) for right colectomy was introduced to overcome these issues. This study compared the short-term outcomes of double incision laparoscopic right colectomy (DILrC) with conventional multiport laparoscopic right colectomy (LrC).

Methods: The DILrC was initiated with a 3 to 5 cm umbilical incision and the placement of a wound protector. A 5.5 size surgical glove was fixed to the wound protector, and three ports were inserted through the tips of the glove fingers to induce pneumoperitoneum and to create working channels for the laparoscopic instruments. An additional port was then made on the right lower quadrant where a postoperative drainage tube would be inserted.
Thirty-three patients were included in this study, from January 2010 to September 2012,. The operative time, blood loss, number of harvested lymph nodes, length of hospital stay, conversion, intra and postoperative complications were retrospectively examined.

Result: Six patients were treated by DILrC and 27 patients by LrC. There were no significant differences in the age, gender, body mass index. The median operation time was 194 minutes (range, 151-281) in DILrC and 223 minutes (range, 127-342) in LrC. The median blood loss was 24 ml (range, 0-208) in DILrC and 10 ml (range, 0-500) in LrC. The median number of harvested lymph nodes for malignant cases was 16 (range, 16-33) in DILrC and 16 (range, 5-53) in LrC. The median length of hospital stay was 11.5 days (range, 7-16) in DILrC and 11 days (range, 7-50) in LrC. No cases were converted to a multiport laparoscopic surgery or an open procedure. No intra- or postoperative complications were observed in either group.

Conclusion: The short term results of DILrC were comparable to LrC. DILrC can be used as an alternative to conventional LrC.

Session: Poster Presentation

Program Number: P505