Single-incision laparoscopic colorectal surgery, experience with 50 consecutive cases.

van den Boezem, Peter B; Sietses, Colin

BACKGROUND Single-incision laparoscopic surgery (SILS) is one of the most recent developments in laparoscopic surgery. Having proven its effectiveness in cholecystectomy and appendectomy, the feasibility of SILS in more advanced surgery, such as hemicolectomy and low anterior resection, is now a point of discussion. METHODS This study reports on the results of the first 50 SILS colorectal operations at our institution. Twenty right hemicolectomies, 16 sigmoid resections, 9 low anterior resections, and 5 total colectomies were performed. Nineteen patients were operated for benign colonic diseases, 31 for malignant disease. RESULTS Mean operative time was 130 min, and the median duration of postoperative hospital stay was 6 days. None of the procedures needed conversion to a laparotomy, but four patients were converted to a multiport laparoscopy. In one case, an anastomotic leakage occurred, which was treated by creating a diverting ileostomy laparoscopically. Minor complications were four wound infections and two incisional hernias. CONCLUSION SILS colectomy is a safe and feasible procedure even in more complex cases. Comparative studies are needed to demonstrate advantages over traditional laparoscopic surgery.