Single-port laparoscopy in colorectal surgery.
OBJECTIVE
Laparoscopy is the approach of choice for the majority of colorectal disorders that require a minimally invasive abdominal operation. As the emphasis on minimizing the technique continues, natural orifice surgery is quickly evolving. The authors utilized an embryologic natural orifice, the umbilicus, as sole access to the abdomen to perform a colorectal procedure. Herein, we present our initial experience of single-port laparoscopic colorectal surgery using a Uni-X Single-Port Access Laparoscopic System (Pnavel Systems, Morganville, New Jersey, USA) with a multi-channel cannula and specially designed curved laparoscopic instrumentation.


METHODS
The abdomen was approached through a 3.5 cm incision via the umbilicus and a single-port access device was utilized to perform a right hemicolectomy on a patient with an unresectable caecal polyp and a body mass index of 35. Ligation of the ileocolic artery was done with a LigaSure Device (Covidien Ltd, Norwalk, Connecticut, USA), and was followed by colonic mobilization, extraction and extracorporeal ileocolic anastomosis.


RESULTS
The total operative time was 115 min with minimal blood loss. Hospital stay was 4 days with no undue sequelae.


CONCLUSIONS
Single-port laparoscopic surgery may allow common colorectal laparoscopic operations to be performed entirely through the patient's umbilicus and enable an essentially scarless procedure. Additional experience and continued investigation are warranted.
Remzi
F H
FH
Department of Colorectal Surgery, Cleveland Clinic, Cleveland, Ohio 44195, USA. remzif@ccf.org
Kirat
H T
HT
Kaouk
J H
JH
Geisler
D P
DP
D000368:Aged; D002430:Cecal Neoplasms / Q000473:pathology / Q000601:surgery*; D003082:Colectomy / Q000379:methods; D003113:Colonoscopy / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007417:Intestinal Polyps / Q000175:diagnosis / Q000601:surgery*; D020706:Laparoscopes; D010535:Laparoscopy / Q000379:methods*; D007902:Length of Stay; D019060:Minimally Invasive Surgical Procedures / Q000379:methods; D010149:Postoperative Pain / Q000503:physiopathology; D016896:Treatment Outcome; D014472:Umbilicus