title: Hybrid single-incision laparoscopic sigmoidectomy: the effective use of small incision.
abstract: OBJECTIVE
  Single-incision laparoscopic colectomy (SILC) often requires steeper Trendelenburg positioning to displace or keep the small intestine away from the operative site. We have developed hybrid SILC in which we make a transumbilical incision to extract the specimen first and utilize a multiflap gate (MFG).
  
  
  METHODS
  MFG was inserted through a 4.0-cm transumbilical incision, and a surgical towel was inserted via MFG and displaced the small intestine away from the operative site. Three 5-mm ports were placed in the converter sheet. Almost all the operative procedures were the same as usual laparoscopic sigmoidectomy. In the course of laparoscopic procedures, whenever we felt stress, we used the techniques of open surgery via MFG.
  
  
  RESULTS
  In 3 patients, the procedure was successfully completed without any complications.
  
  
  CONCLUSIONS
  Our procedure can be easily performed, which enables surgeons to achieve SILC safe and easy compared with conventional technique.
authors.affiliation: Department of Surgery, Fukui Prefectural Hospital, Fukui, Japan. yasumitsuhira@yahoo.co.jp
authors.forename: Yasumitsu
authors.initials: Y
authors.lastname: Hirano
authors.forename: Masakazu
authors.initials: M
authors.lastname: Hattori
authors.forename: Hirotaka
authors.initials: H
authors.lastname: Kitamura
authors.forename: Kazuya
authors.initials: K
authors.lastname: Maeda
authors.forename: Kenji
authors.initials: K
authors.lastname: Douden
authors.forename: Yasuo
authors.initials: Y
authors.lastname: Hashizume
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D012809:Colon, Sigmoid / Q000601:surgery*; D003110:Colonic Neoplasms / Q000601:surgery*; D013505:Digestive System Surgical Procedures / Q000295:instrumentation / Q000379:methods; D004867:Equipment Design; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D008875:Middle Aged