• Skip to primary navigation
  • Skip to main content
  • Skip to primary sidebar
  • Skip to footer

SAGES

Reimagining surgical care for a healthier world

  • Home
    • COVID-19 Annoucements
    • Search
    • SAGES Home
    • SAGES Foundation Home
  • About
    • Who is SAGES?
    • SAGES Mission Statement
    • Advocacy
    • Strategic Plan, 2020-2023
    • Committees
      • Request to Join a SAGES Committee
      • SAGES Board of Governors
      • Officers and Representatives of the Society
      • Committee Chairs and Co-Chairs
      • Full Committee Rosters
      • SAGES Past Presidents
    • Donate to the SAGES Foundation
    • Awards
      • George Berci Award
      • Pioneer in Surgical Endoscopy
      • Excellence In Clinical Care
      • International Ambassador
      • IRCAD Visiting Fellowship
      • Social Justice and Health Equity
      • Excellence in Community Surgery
      • Distinguished Service
      • Early Career Researcher
      • Researcher in Training
      • Jeff Ponsky Master Educator
      • Excellence in Medical Leadership
      • Barbara Berci Memorial Award
      • Brandeis Scholarship
      • Advocacy Summit
      • RAFT Annual Meeting Abstract Contest and Awards
  • Meetings
    • NBT Innovation Weekend
    • SAGES Annual Meeting
      • 2023 Scientific Session Call For Abstracts
      • 2023 Emerging Technology Call For Abstracts
    • CME Claim Form
    • Industry
      • Advertising Opportunities
      • Exhibit Opportunities
      • Sponsorship Opportunities
    • Future Meetings
    • Past Meetings
      • SAGES 2022
      • SAGES 2021
    • Related Meetings Calendar
  • Join SAGES!
    • Membership Benefits
    • Membership Applications
      • Active Membership
      • Affiliate Membership
      • Associate Active Membership
      • Candidate Membership
      • International Membership
      • Medical Student Membership
    • Member News
      • Member Spotlight
      • Give the Gift of SAGES Membership
  • Patients
    • Healthy Sooner – Patient Information for Minimally Invasive Surgery
    • Patient Information Brochures
    • Choosing Wisely – An Initiative of the ABIM Foundation
    • All in the Recovery: Colorectal Cancer Alliance
    • Find a SAGES Member
  • Publications
    • SAGES Stories Podcast
    • SAGES Clinical / Practice / Training Guidelines, Statements, and Standards of Practice
    • Patient Information Brochures
    • TAVAC – Technology and Value Assessments
    • Surgical Endoscopy and Other Journal Information
    • SAGES Manuals
    • SCOPE – The SAGES Newsletter
    • COVID-19 Annoucements
    • Troubleshooting Guides
  • Education
    • OpiVoid.org
    • SAGES.TV Video Library
    • Safe Cholecystectomy Program
      • Safe Cholecystectomy Didactic Modules
    • Masters Program
      • SAGES Facebook Program Collaboratives
      • Acute Care Surgery
      • Bariatric
      • Biliary
      • Colorectal
      • Flexible Endoscopy (upper or lower)
      • Foregut
      • Hernia
      • Robotics
    • Educational Opportunities
    • HPB/Solid Organ Program
    • Courses for Residents
      • Advanced Courses
      • Basic Courses
    • Video Based Assessments (VBA)
    • Robotics Fellows Course
    • MIS Fellows Course
    • Facebook Livestreams
    • Free Webinars For Residents
    • SMART Enhanced Recovery Program
    • SAGES OR SAFETY Video
    • SAGES at Cine-Med
      • SAGES Top 21 MIS Procedures
      • SAGES Pearls
      • SAGES Flexible Endoscopy 101
      • SAGES Tips & Tricks of the Top 21
  • Opportunities
    • NEW-Area of Concentrated Training Seal (ACT)-Advanced Flexible Endoscopy-Coming Soon!
    • SAGES Fellowship Certification for Advanced GI MIS and Comprehensive Flexible Endoscopy
    • Multi-Society Foregut Fellowship Certification
    • SAGES Research Opportunities
    • Fundamentals of Laparoscopic Surgery
    • Fundamentals of Endoscopic Surgery
    • Fundamental Use of Surgical Energy
    • Job Board
    • SAGES Go Global: Global Affairs and Humanitarian Efforts
  • Search
    • Search All SAGES Content
    • Search SAGES Guidelines
    • Search the Video Library
    • Search the Image Library
    • Search the Abstracts Archive
  • Store
    • “Unofficial” Logo Products
  • Log In

Single Port Laparoscopic Colorectal Surgery Shows No Drawbacks Compared to Standard Laparoscopic Surgery: Results of a Case Match Study

Grace Montenegro, MD, Joseph Frenkel, MD, Margaret Shields, Gerald Marks, MD, John Marks, MD. Lankenau Medical Center.

Single port (SP) colorectal surgery has been characterized as a gimmick with limited applicability in regards to procedure, disease and patient characteristics. Although theoretically attractive for patients, there is question if SP procedures can safely be performed and if it offers any disadvantages or advantages to multiport (MP) laparoscopic colorectal surgeries. We hypothesize that SP is at least equivalent to MP surgery, and can be a safe alternative. Moreover, we intend to examine SP for the full spectrum of colorectal procedures.

Case-matched retrospective analysis of a prospectively maintained database of a single colorectal surgeon to compare perioperative outcomes in single port vs. multiport laparoscopic surgery (SP/MP) for total (5/5), right (24/24) and left (51/51) colectomy, stoma (3/3), and TME (12/12) surgery was performed. Case-match (SP/MP) included preoperative diagnosis, disease location, procedure, BMI (25.6/26.2kg/m2; 17.2-38.7), age (60/60, 19-88 yo), gender (53/53 women), history of previous abdominal operation (50/47%) and pelvic radiation (12/12%). Perioperative outcomes, morbidity, mortality, local recurrence and 5-year survival for cancer patients were analyzed. Subset analysis was performed for surgery type. Statistically significant differences were identified using Student’s t-Test.

Case match of 159 SP cases with 1617 MP found 95 matches for analysis (SP/MP). Preoperative diagnoses included diverticulitis (46/46), cancer (27/27), polyps (14/14), ulcerative colitis (3/3), colonic inertia (2/2), rectal prolapse (2/2) and volvulus (1/1). There was lower mean EBL in SP (109/177cc, p=0.03) but no difference in transfusion requirement (0/1). Decreased OR time for SP left colectomy (206/244min, p=0.01) with a trend to shorter for SP found in all procedures (217/249min, p=0.05). 99% SP and 98% MP had no intra-operative complications. Complications included enterotomy (0/1), lost needle (1/0) and presacral bleeding (0/1). Conversion to open was equivalent (0/1), with 6.3% of SP requiring additional ports. Mean largest incision was smaller for SP (3.1/5.2cm, p=0.01). There were no differences in specimen length (27.9/31.3cm, p=0.42). Overall LN harvest for SP compared to MP did not show a difference. There were no differences in return of bowel function (flatus (POD 2/2) and bowel movements (POD 3/3)) or length of hospital stay (POD 4/4). There were no differences in perioperative morbidity (12/17%, p=0.55) such as anastomotic leak (1/1) or delayed morbidity such as wound infection (1/0) or incisional hernia (0/1). There were no mortalities. There was no difference in local recurrence, distant metastasis or overall 5-year survival (cancer patients only) between SP and MP.

Single port is a safe alternative to multiport laparoscopic colorectal surgery across the full array of procedures, in equivalent patients. This study demonstrates SP has less blood loss, smaller incisions and is quicker in left colectomy, and trends to quicker across all procedures. Conversion and morbidity rates are equivalent to MP, without compromise in quality of surgical technique. No differences in discharge criteria were shown. While proper training is essential, concerns regarding the inability to use SP laparoscopic colorectal surgery safely are unfounded. These issues will require further study as SP laparoscopic colorectal surgery is practiced more widely.

View Poster

127

Share this:

  • Twitter
  • Facebook
  • LinkedIn
  • Pinterest
  • WhatsApp
  • Reddit

Related

« Return to SAGES 2014 abstract archive

Our Mission

Innovate, educate and collaborate to improve patient care.

Recently, on SAGES…

Critical View of Safety (CVS) Challenge QR Code

The SAGES Critical View of Safety Challenge – Donate Your Lap Chole Videos!

The Society of American Gastrointestinal and Endoscopic Surgeons is hosting the first Artificial Intelligence Data Challenge conducted by surgeons. The aim of this challenge is to generate a large and diverse dataset of laparoscopic cholecystectomy videos, annotated with respect to the subcomponents of the Critical View of Safety (CVS). Computer scientists from all over the […]

Respuesta de SAGES al Estudio NordICC sobre el beneficio de las colonoscopias de detección

SAGES desea aclarar los resultados del estudio NordICC y colocarlos en contexto de los esfuerzos de varias agencias nacionales para reducir el riesgo de cáncer colorrectal – la segunda causa de muerte por cáncer más frecuente en los Estados Unidos-, mediante la promoción de la detección y tratamiento oportuno de las lesiones.

SAGES Response to NordICC Study Regarding Benefit of Screening Colonoscopies

The NordICC Study recently published in The New England Journal of Medicine and widely reported on by media outlets has raised questions regarding the benefit of screening colonoscopy in lowering the risk of colorectal cancer and cancer-related deaths among otherwise healthy and symptom-free men and women aged 55 to 64. Provocative headlines and commentaries have […]

Contact SAGES

Society of American Gastrointestinal and Endoscopic Surgeons
11300 W. Olympic Blvd Suite 600
Los Angeles, CA 90064 USA
webmaster@sages.org
Tel: (310) 437-0544

Find Us Around the Web!

  • Facebook
  • Twitter
  • YouTube

Important Links

SAGES 2023 Meeting Information

Healthy Sooner: Patient Information

SAGES Guidelines, Statements, & Standards of Practice

SAGES Manuals

 

  • taTME Study Info
  • Foundation
  • SAGES.TV
  • MyCME
  • Educational Activities

Copyright © 2023 Society of American Gastrointestinal and Endoscopic Surgeons