Single Port Laparoscopic Right Colectomy for Cancer a preliminary experience

Elie K Chouillard, MD, Elias Chahine, MD, Andrew Gumbs, MD, FACS, Beatrice Vinson Bonnet, MD, Adrian Lobontiu, MD

Paris Poissy Medical Center

Introduction: Natural Orifice Translumenal Endoscopic Surgery (NOTES) is an emerging surgical phenomenon. While the development of “pure” NOTES techniques in humans is still hindered by major technical hurdles, the “Hybrid” NOTES variants and mainly Single Portlaparoscopic techniques have been increasingly reported. The domains of application of such techniques include cholecystectomy, appendectomy, bariatrics, colorectal surgery, andnumerous other clinical settings. The pertinence of these techniques in colorectal surgery may even be more relevant due to the obviate need for a surgical incision in order to retrieve the specimen. We have developed a “single Port” variant of laparoscopic right colectomy (sRC) for patients with either benign or malignant disease. By further reducing the invasiveness of the laparoscopic approach, we may reduce post-operative pain, better preserve the abdominal wall, and enhance cosmesis.

Methods and procedures: sRC was attempted in 44 patients with cancer. Exclusion criteria were morbid obesity (BMI of more than 40 kg/m2) and the presence of major prior abdominal surgery. The study was approved by the local Ethics Board. The written patient’ informed consent was always required. The technique was performed using a transumbilical incision with only three abdominal ports located on a special platform.

Results: The procedure was a success in 40 patients (91 %). Seven patients had additional procedures including cholecystectomy, hysterectomy, oophorectomy, or intraperitoneal chemohyperthermia. In 2 patients, conversion to more conventional laparoscopy occurred, with one or more abdominal ports added. In 2 other patients, conversion to laparotomy was necessary. The mean operative time was 98 minutes (55-183). The post-operative rate of complications was 9 % (1 obstruction, 1 leak, 1 hemorrhage, 1 abscess). One patient was reoperated. The mean length of hospital stay was 5days (3-17).

Conclusion: Our Single Port variant of laparoscopic right colectomy (sRC) was found to be a sure and feasible technique for patients with colon cancer.

Session: Poster Presentation

Program Number: P120