Single Incision Trans-Umbilical Laparoscopic Surgery of the Colon and Rectum with Conventional Laparoscopic Surgical Instruments

wu shuodong, su yang, tian yu, kong jing, fan ying, Siwo Ernest Amos. the first department of mininally invasive and biliary surgery, shengjing hospital of China Medical Universityl

ABSTRACT Objective: To explore the feasibility and technical maneuverability of conventional laparoscopic surgical instruments in single incision trans-umbilical laparoscopic surgery of the colon and rectum. Method: From December 2009 to July 2010, data was collected from patients who had single incision trans-umbilical laparoscopic surgery of colon and rectum at the Minimal Invasive and Biliary Surgery unit of China Medical University’s Shengjing Hospital. The group included seven female and six male patients of mean age 58 years, of which was six rectal cancer, one sigmoid colon cancer, one ascending colon cancer, one sigmoid polyp, one lymphatic hygroma of ileocecus, one ulcerative colitis lesion of ileocecus, one adenomatous polyposis of colon and one diffusive ulcerative colitis. Six different procedure were performed including four cases of dixon’s operation, two cases of mile’s operation, two cases of ileocecal resection, two cases of sigmoid colon resection, one case of right colectomy and two cases of total colon resection. All the operations were accomplished using conventional laparoscopic surgical instruments inserted through a single umbilical incision measuring 2cm~3cm.
Results: the operative time is 120 to 210 minutes in dixon’s operation, 120 and 420 minutes in two mile’s operation, 60 and 90 minutes in ileocecal resection, 180 and 450 minutes in total colon resection, 100 to 120 minutes in sigmoid resection, and 120 minutes in right colectomy. The blood loss is 150 to 350 mL. The average hospital stay is 7.5 days. One case of mile’s operation was converted into multiple port laparoscopic operation because of severe adhesion. One case of slight anastomotic leakage was found post total colon resection and cured by non-operative treatment.
Conclusion: Single incision trans-umbilical laparoscopic surgery of the colon and rectum utilizing conventional laparoscopic surgical instruments is feasible and safe.

KEY WORDS Single incision trans-umbilical laparoscopic surgery; Colorectal surgery

Session: Poster
Program Number: P363
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