Single-port laparoscopic sphincter-saving mesorectal excision for rectal cancer: report of the first 4 human cases.
OBJECTIVE
Single-port laparoscopic rectal surgery can be performed using the principles of oncologic surgery in institutes experienced in laparoscopy with the advantages of minimally invasive surgery.


METHODS
Sphincter-saving mesorectal excision in 4 human cases via a single laparoscopic port.


METHODS
A university hospital and a private hospital.


METHODS
A series of 4 patients who underwent single-port laparoscopic sphincter-saving rectal resection for rectal cancer. Two of them were total and 2 were partial mesorectal excisions.


METHODS
An umbilical incision was made to place the multichannel single port. The sigmoid colon was hung to the left lateral abdominal wall using an intracorporeal stitch passing through its appendices epiploicae to achieve medial dissection and vascular ligation. The mesorectum was sharply dissected down to the pelvic floor. Endoscopic linear roticulating staplers were used to divide the rectum and proximal colon. A specimen was retrieved using an extraction bag through the umbilicus. Anastomosis was performed using a circular stapler, or pull-through hand-sewn anastomosis was performed.


METHODS
Duration of the operation, length of hospital stay, surgical complications, wound size, and histopathologic data.


RESULTS
There were no perioperative or postoperative complications. Mean operative time was 347 minutes (range, 240-480 minutes). Mean hospital stay was 4.25 days (range, 4-5 days). Mean wound size was 3.5 cm (range, 3-4 cm). Mean number of harvested lymph nodes was 15 (range, 8-28).


CONCLUSIONS
With the help of sophisticated surgical technology and techniques, single-port laparoscopic surgery for rectal cancer will be feasible while also maintaining oncologic principles and patient safety.
Department of Surgery, Istanbul University, Turkey. ihhamzaoglu@yahoo.com
Ismail
I
Hamzaoglu
Tayfun
T
Karahasanoglu
Bilgi
B
Baca
Adem
A
Karatas
Erman
E
Aytac
Arif Sami
AS
Kahya
D000368:Aged; D013505:Digestive System Surgical Procedures / Q000379:methods*; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D012004:Rectal Neoplasms / Q000601:surgery*; D012007:Rectum / Q000601:surgery