Umbilical incision laparoscopic surgery with one assist port for anterior resection.
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.
Kawahara
Hidejiro
H
Department of Surgery, Kashiwa Hospital, Jikei University School of Medine, Chiba, Japan. kawahide@jikei.ac.jp
Watanabe
Kazuhiro
K
Ushigome
Takuro
T
Noaki
Rohta
R
Kobayashi
Susumu
S
Yanaga
Katsuhiko
K
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