Dan Geisler, MD Associate Staff. West Penn AlleghenyHealth System
Compared to open surgery, the benefits afforded to a patient from a minimally invasive approach for colorectal surgical resections are very well documented. With heightened interest in even less invasive surgery, single incision laparoscopic colorectal surgery is quickly gaining acceptance. While the access technique was first described in 2007 for colorectal resective procedures, large series and indications for its application are lacking.
Between January 2009 and December 2010, all patients undergoing single incision colorectal procedures by a single surgeon were prospectively entered into an IRB-approved database and studied with regards to perioperative and postoperative events, morbidity and mortality.
58 consecutive patients (Age 19-83) underwent single incison laparoscopic colorectal procedures for inflammatory disease. There was one conversion (1.7%) to an open operation due to unclear anatomy from intra-abdominal adhesions. 29 patients (50%) had previous abdominal surgery and the average BMI was 25.4 (15-36). Ten patients (17%) required placent of additional ports (1: N=7; 2: N=1; 3: N=2). Primary diagnosis included ulcerative colitis (N=40), Crohn’s disease (N=9), and diverticulitis (N=9). The average operating room time was 110 minutes (13-222) and mean length of incision was 2.98cm (1.2-7.8). Estimated blood loss was 121 mL (0-700). Procedures performed included total abdominal colectomy (16), total proctocolectomy with J-pouch (11), small bowel resection (9), completion proctectomy with J-pouch (7) and loop ileostomy (1). There was no mortality. Overall morbidity was 38%. Average length of stay was 5.6 days (2-18). No patients required reoperation.
With proper patient selection and laparoscopic experience, single incision laparoscopic surgery can be performed safely for even the most complex and inflammatory of colorectal disorders.
Session Number: Poster – Poster Presentations
Program Number: P112