Single-port laparoscopic colorectal surgery: Early clinical experience

Background: Single-port laparoscopic surgery (SPLS) for colorectal pathology is an advanced technique wherein laparoscopic surgery is carried out through a single small incision hidden in the umbilicus. Advantages of this technique over standard laparoscopy are still under investigation. This study reports the initial experience and short-term outcomes of colorectal SPLS procedures in a single academic-based institution. Subjects and Methods: All patients who underwent SPLS for colorectal procedures between February 2010 and March 2011 were recruited into this prospective study. Patients' demographics, pathology, and intraoperative and postoperative outcomes were collected. Time to first flatus and bowel movement, postoperative pain, duration of hospital stay, and complications were also measured. Results: Twenty patients underwent colorectal SPLS: 17 patients underwent right hemicolectomy, and 3 patients had sigmoid resection. Mean age was 66±14 years, and body mass index was 25±4? kg/m². Median operative time for right hemicolectomy was 120 minutes (range, 110-136 minutes), and that for sigmoid resection was 158 minutes (range, 86-177 minutes). Mean measured incision length was 4.2±1.2? cm (range, 2.5-7? cm). Two cases were converted to standard multiport laparoscopy, and 1 was converted to open surgery Postoperatively, there was no mortality. Intra-abdominal abscess was observed in 3 patients. Median postoperative stay was 3 days (range, 3-3 days). Median number of lymph nodes extracted was 15 (range, 12-23). Conclusions: The SPLS is technically feasible with proper patient selection for a variety of applications in colorectal surgery. Improvement in instrumentation and technology is likely to expand the role of SPLS in minimally invasive surgery. It is important to audit outcomes as this novel approach is introduced.