Single incision laparoscopic surgery (SILS) is a novel surgical technique that has been used in a number of abdominal surgical procedures. The primary advantage of this technique is cosmesis through a virtually scarless single umbilical incision. There is currently limited data on the safety, efficacy and learning curve when applying this technique to colorectal resections.
METHODS AND PROCEDURES
Prospective data was collected from a single surgeon database of SILS colonic resections preformed, comprising an initial experience of 5 procedures (May 2009-Sept 2009). All operations were performed by a single surgeon experienced in laparoscopic surgery. Case controls undergoing traditional laparoscopic colon resections by the same surgeon were matched for age, sex and operative procedure. Data from these patients was also collected and the SILS and laparoscopic groups were compared based on outcome measures of operative time, complications, and length of hospital stay.
5 SILS colonic resections were performed between May and September of 2009 (4 right hemicolectomies, 1 sigmoid resection). Mean (range) operative time for the SILS cases was 95 (77-153)min vs 72 (30-90)min for the laparoscopic resections. Time to discharge was 3.6 (2-6)days for the SILS patients and 4.6 (3-7)days for the laparoscopic patients. There were no peri-operative complications or patient deaths. Operative time was very consistent throughout the 4 SILS right hemicolectomies performed (85,81,80,77min)
Early results demonstrate that single incision laparoscopic colorectal surgery can be performed with operative times and complication rates comparable to a standard laparoscopic approach. The learning curve for an experienced laparoscopic surgeon appears to be minimal with properly selected cases. Greater numbers of patients and continued experience with this technique are required to confirm these results.
Program Number: P532