Total intracorporeal anastomosis during single-port laparoscopic right hemicolectomy for carcinoma of colon: a new step forward.

Morales-Conde, Salvador; Moreno, Joaquin García; Gómez, Jesus Cañete; Socas, María; Barranco, Antonio; Alarcón, Isaias; Casado, María; Cadet, Jean-Marie; Martín-Cartes, Juan

BACKGROUND Laparoscopic surgery is a feasible option for colonic carcinoma as short-and long-term results show. This technique is as safe and effective as the open approach. Single-port access surgery is considered a new minimally invasive approach in the search for better cosmetic results and less postoperative pain. One of the goals of single-port surgery is to preserve the satisfactory oncological results obtained by standard laparoscopy. This study presents the first single-port access right hemicolectomy for carcinoma of colon with intracorporeal anastomosis. METHODS The authors report a single-port access right hemicolectomy in a 59-year-old male patient with a neoplasm of the cecum stage IIA (T3, N0) according to the TNM classification. RESULTS A transumbilical single-port access right hemicolectomy was performed with no additional trocars and total intracorporeal anastomosis. Operative time was 140 minutes. No intraoperative or postoperative complications were reported. CONCLUSION Single-port access right hemicolectomy with intracorporeal anastomosis is a feasible and safe technique when performed by experienced laparoscopic surgeons. This approach must follow the basic principles of laparoscopic right hemicolectomy to achieve the same oncological results. The advantages of a total intracorporeal anastomosis include that there is no need to enlarge the umbilical incision and that avoid traction of the pedicle of the mesenterium of the transverse colon during the extracorporeal anastomosis.