title: Single-port laparoscopic diverting sigmoid colostomy.
abstract: BACKGROUND
  Single-port laparoscopic surgery has been described for various colorectal conditions. Here, we report the first 4 single-port laparoscopic sigmoid colostomies for fecal diversion.
  
  
  METHODS
  A 1.5-cm-round incision was made on the skin at a previously marked colostomy site. A wound retractor was inserted and an access platform with four 5-mm trocars was attached to the wound retractor. The sigmoid colon was mobilized using electrocautery, laparoscopic scissors, or an advanced bipolar device. A standard Brooke colostomy was created through the initial skin incision.
  
  
  RESULTS
  Four elective single-port laparoscopic diverting colostomies were performed. Indications included obstructing colon and rectal cancers and intractable Crohn's proctitis. The average operative time was 73 minutes (range, 53-105), and blood loss was minimal (<50 mL). There were no intraoperative complications. Three of 4 patients received oral analgesia, and one patient received patient-controlled intravenous analgesia postoperatively. The average time to passage of flatus was 1 day. Diet was advanced either on the day of surgery or on postoperative day 1. The length of hospital stay ranged from 0 to 15 days.
  
  
  CONCLUSIONS
  Single-port laparoscopic sigmoid colostomy is an effective technique that allows full intra-abdominal visualization and colonic mobilization while eliminating the need for additional skin incisions other than the colostomy site itself.
authors: Department of Surgery, University of Massachusetts Medical School, Worcester, Massachusetts 01605, USA.
authors: Hoang M L
authors: HM
authors: Nguyen
authors: Marlin W
authors: MW
authors: Causey
authors: Scott R
authors: SR
authors: Steele
authors: Justin A
authors: JA
authors: Maykel
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D012809:Colon, Sigmoid / Q000601:surgery*; D003108:Colonic Diseases / Q000601:surgery; D003125:Colostomy / Q000379:methods*; D003424:Crohn Disease / Q000601:surgery; D005260:Female; D005767:Gastrointestinal Diseases / Q000601:surgery*; D006801:Humans; D007415:Intestinal Obstruction / Q000601:surgery; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D019370:Observation; D011349:Proctitis / Q000601:surgery; D012004:Rectal Neoplasms / Q000601:surgery; D016896:Treatment Outcome