title: Single incision laparoscopic total proctocolectomy with ileopouch anal anastomosis.
abstract: 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.
authors.affiliation: Department of Colorectal Surgery, The Digestive Diseases Institute, Cleveland Clinic, Cleveland, OH, USA.
authors.forename: D P
authors.initials: DP
authors.lastname: Geisler
authors.forename: E T
authors.initials: ET
authors.lastname: Condon
authors.forename: F H
authors.initials: FH
authors.lastname: Remzi
mesh_terms: 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*