title: Suprapubic single-incision laparoscopic right hemicolectomy with intracorporeal anastomosis.
abstract: BACKGROUND
  Single-incision laparoscopy (SIL) has gained significance recently. The umbilicus has been the preferred access site for SIL. Suprapubic access site (SAS) can be an alternative, especially for a right hemicolectomy (RH).
  
  
  METHODS
  Between November 2011 and July 2012, 7 consecutive patients underwent suprapubic SIL RH (SSILRH). The median age was 53 years, and the median body mass index was 23.9 kg/m2. Indications for surgery included appendicular tumor (1) and adenocarcinoma of the right colon (6). Three reusable trocars were used, and the resection was performed through the SAS. An intracorporeal linear stapled anastomosis was performed, the mesenteric defect was closed, and the access site was used for specimen extraction.
  
  
  RESULTS
  No patient required additional trocars or conversion to an open surgery. The median laparoscopic time was 222 minutes, and the median final incision length was 50 mm. The median Visual Analogue Scale score (0-10) at 6, 18, 30, 42, 54, 66, and 78 postoperative hours was 6, 6, 2, 2, 2, 2, and 2, respectively. The median hospital stay was 4 days.
  
  
  CONCLUSIONS
  SSILRH is useful because the SAS can be enlarged for extraction of the specimen without compromising the cosmetic outcome. The mesocolic and mesenteric dissections are on the same axis as the access site. The intracorporeal anastomosis can be performed without traction. Finally, positioning of the operative table improves exposure of the operative field and allows the surgeon to maneuver the colon and small bowel intracorporeally.
authors: 1Saint-Pierre University Hospital, Brussels, Belgium.
authors: Giovanni
authors: G
authors: Dapri
authors: Sergio
authors: S
authors: Carandina
authors: Perrine
authors: P
authors: Mathonet
authors: Jacques
authors: J
authors: Himpens
authors: Guy-Bernard
authors: GB
authors: Cadière
mesh_terms: D000328:Adult; D000368:Aged; D000714:Anastomosis, Surgical / Q000009:adverse effects / Q000295:instrumentation* / Q000379:methods*; D003082:Colectomy / Q000009:adverse effects / Q000295:instrumentation* / Q000379:methods*; D003106:Colon / Q000601:surgery; D005260:Female; D006801:Humans; D007082:Ileum / Q000601:surgery; D010535:Laparoscopy / Q000009:adverse effects / Q000295:instrumentation* / Q000379:methods*; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D011183:Postoperative Complications / Q000209:etiology
keywords: intracorporeal anastomosis; laparoscopy; right hemicolectomy; single-access; single-incision; single-port; single-site