title: No visible scar (NVIS) colectomy: a new approach to minimal access surgery to the colon.
abstract: BACKGROUND
  Minimally invasive surgery continues to revolutionize surgical standards with trends toward further minimalization and improved cosmesis. Approaches such as laparoendoscopic single-site surgery (LESS) and natural orifice translumenal endoscopic surgery (NOTES) have thus emerged. The authors devised an alternative method for a more efficient approach to minimally invasive surgery called no visible scar (NVIS). This study describes NVIS and its ability to provide operative capacity and outcomes similar to other minimal access techniques, but with improved cosmesis and possibly decreased associated complications.
  
  
  METHODS
  This is a retrospective analysis of patients undergoing colectomy between June 2009 and March 2010 to evaluate our outcomes with the NVIS technique (surgical approach via a 4-5 cm suprapubic site for inserting trocars/multiport and specimen extraction, with a 5-mm umbilical incision for a single trocar). Outcome measures included intraoperative complications, postoperative morbidity, and cosmetic outcome.
  
  
  RESULTS
  Ten patients with a mean age of 60.3 years underwent NVIS colectomy. The average operating time was 161.3 minutes with a mean blood loss of 56.5 mL. There were no conversions to open surgery. One patient required additional trocar placement. No perioperative complications were encountered. On follow-up, no wound complications were noted and all patients appeared satisfied with their cosmetic outcome. One patient was readmitted for a low-grade fever, but the NVIS technique was not identified as a contributor.
  
  
  CONCLUSIONS
  NVIS is a safe and feasible minimal access alternative, which improves cosmesis and may decrease complications associated with other minimally invasive techniques. Further analysis in a larger patient population is warranted to support our findings.
authors.affiliation: University of California-Irvine Medical Center, Orange, CA, USA.
authors.forename: Vicrumdeep S
authors.initials: VS
authors.lastname: Tung
authors.forename: Brian
authors.initials: B
authors.lastname: Buchberg
authors.forename: Hossein
authors.initials: H
authors.lastname: Masoomi
authors.forename: Kevin
authors.initials: K
authors.lastname: Reavis
authors.forename: Ninh T
authors.initials: NT
authors.lastname: Nguyen
authors.forename: Steven
authors.initials: S
authors.lastname: Mills
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Stamos
mesh_terms: D000368:Aged; D002921:Cicatrix / Q000209:etiology / Q000473:pathology / Q000517:prevention & control*; D003082:Colectomy / Q000009:adverse effects*; D003108:Colonic Diseases / Q000150:complications / Q000473:pathology / Q000601:surgery*; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects* / Q000379:methods*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013536:Suture Techniques; D016896:Treatment Outcome; D014945:Wound Healing