Single incision laparoscopic total proctocolectomy with ileopouch anal anastomosis.
OBJECTIVE
We present our initial experience of a single port laparoscopic total proctocolectomy with ileoanal J pouch anastomosis. The single incision laparoscopic surgery (SIL), (Covidien, Norwalk, Connecticut, USA) device with a multichannel cannula and specially designed curved laparoscopic instrumentation were used.


METHODS
A patient with familial adenomatous polyposis underwent restorative proctocoectomy. A colonoscopy had demonstrated nearly 1000 polyps in the colon with several 1-cm polyps in the rectum. The abdomen was entered through a 2.5 cm incision sited preoperatively for the temporary ileostomy. The single port device was inserted and a total proctocolectomy was performed. Ligation of the vessels was performed with the Ligasure (Covidien). The colon and rectum were extracted through the SIL site. An 18-cm ileoanal J pouch was created extracorporeally. The pouch anal anastomosis was performed intracorporeally and a diverting loop ileostomy created through the SIL port site.


RESULTS
The operating time was 172 min. Blood loss was 100 ml and the hospital stay was 4 days without any complication. The patient had a virtually scar-less abdomen other than the site of the loop ileostomy.


CONCLUSIONS
Single port laparoscopic surgery may allow complex colorectal surgery to be performed resulting in a virtually scar-less procedure.
Geisler
D P
DP
Department of Colorectal Surgery, The Digestive Diseases Institute, Cleveland Clinic, Cleveland, OH, USA.
Condon
E T
ET
Remzi
F H
FH
D011125:Adenomatous Polyposis Coli / Q000601:surgery*; D000293:Adolescent; D000714:Anastomosis, Surgical / Q000379:methods; D006801:Humans; D007081:Ileostomy / Q000379:methods*; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D016737:Proctocolectomy, Restorative / Q000379:methods*