Single-port laparoscopic repair of a perforated duodenal ulcer: intracorporeal "cross and twine" knotting.
BACKGROUND
Single-port laparoscopic surgery is increasingly used to treat various types of diseases requiring surgical intervention. We present the technique and the results of our simple "cross and twine" intracorporeal knotting approach for treatment of a perforated duodenal ulcer.


METHODS
From January 2009 to October 2009, 13 patients with perforated duodenal ulcers underwent single-port laparoscopic repair. The laparoscopic procedure included peritoneal lavage and suture of the perforation. The omentum above the repair site was then reinforced. After surgery, patients took an H2 receptor antagonist for 8 weeks and then underwent follow-up gastrofiberscopy.


RESULTS
All procedures were completed under the conditions described. The mean operative time was 90.2 ± 24.2 min, and the mean hospital stay was 6.1 ± 0.5 days. The mean number of times that opiates were used for pain was 0.5 ± 1.0, and wound length was 1.9 ± 0.1 cm. There was no operation-related morbidity. Follow-up gastrofiberscopy revealed good lesion healing.


CONCLUSIONS
Single-port laparoscopic repair using the "cross and twine" knotting technique is a feasible and safe procedure, and it may be a less invasive laparoscopic surgical technique for scarless surgical treatment of perforated duodenal ulcers.
Lee
Junhyun
J
Department of Surgery, Bucheon St. Mary's Hospital, The Catholic University of Korea, Bucheon, Gyeongji-do, Korea.
Sung
Kiyoung
K
Lee
Dosang
D
Lee
Wooyoung
W
Kim
Wook
W
D000328:Adult; D000897:Anti-Ulcer Agents / Q000627:therapeutic use; D002921:Cicatrix / Q000517:prevention & control; D003131:Combined Modality Therapy; D004381:Duodenal Ulcer / Q000150:complications / Q000188:drug therapy / Q000601:surgery*; D005240:Feasibility Studies; D005260:Female; D005500:Follow-Up Studies; D006635:Histamine H2 Antagonists / Q000627:therapeutic use; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D010439:Peptic Ulcer Perforation / Q000209:etiology / Q000601:surgery*; D013536:Suture Techniques; D016896:Treatment Outcome; D014472:Umbilicus
D000897:Anti-Ulcer Agents; D006635:Histamine H2 Antagonists