title: Umbilical incision laparoscopic surgery with one assist port for anterior resection.
abstract: BACKGROUND
  A high surgical technique is required for laparoscopic anterior resection using single-incision laparoscopic surgery such as multiport surgery. We report a novel surgical technique of umbilical incision laparoscopic surgery with one assist port which could be performed like conventional multiport surgery.
  
  
  METHODS
  With the patient in the lithotomy position, a 3-cm longitudinal skin incision is made at the umbilicus and carried down to the peritoneum. A 12-mm and two 5-mm trocars are placed through the incision. Another 12-mm trocar is placed for the insertion of laparoscopic coagulation shears and a stapler in the right lower quadrant. After surgery, the trocar in the right lower quadrant is removed and a drain is replaced through the insertion site. The operator mainly uses two trocars, a 5-mm trocar placed at the umbilicus and a 12-mm trocar in the right lower quadrant, making it like conventional laparoscopic surgery.
  
  
  RESULTS
  The median operation time was 195 (range 180-205) min, intraoperative blood loss was 20 (range 0-60) ml, and none of the 3 patients had any complications postoperatively.
  
  
  CONCLUSIONS
  As opposed to surgery with only three ports, so-called single-incision laparoscopic surgery, this operation can be performed much more comfortably if another port is inserted in the right lower quadrant.
authors.affiliation: Department of Surgery, Kashiwa Hospital, Jikei University School of Medine, Chiba, Japan. kawahide@jikei.ac.jp
authors.forename: Hidejiro
authors.initials: H
authors.lastname: Kawahara
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Watanabe
authors.forename: Takuro
authors.initials: T
authors.lastname: Ushigome
authors.forename: Rohta
authors.initials: R
authors.lastname: Noaki
authors.forename: Susumu
authors.initials: S
authors.lastname: Kobayashi
authors.forename: Katsuhiko
authors.initials: K
authors.lastname: Yanaga
mesh_terms: D000368:Aged; D016063:Blood Loss, Surgical; D003082:Colectomy / Q000379:methods*; D015179:Colorectal Neoplasms / Q000601:surgery*; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D013996:Time and Motion Studies