title: Single-port endo-laparoscopic surgery in combined abdominal procedures.
abstract: Single-port endo-laparoscopic surgery has gained support in the surgical community because it is perceived to offer a better postoperative outcome as it requires only a single incision. We write this prospective observational study to ascertain the feasibility and safety of this technique in patients otherwise requiring two operations. Five patients who underwent double procedures with a single-port device were reviewed: Case 1, a transabdominal preperitoneal hernia repair and gastric wedge resection; Case 2, cholecystectomy and diaphragmatic hernia repair; Case 3, oophorectomy and incisional hernia repair; Case 4, anterior resection of the rectum and hepatic segmentectomy; and Case 5, left adrenalectomy and cholecystectomy. Patient demographics, type of port used, operative time, complications and incision length were collected. Mean operative time for the cases ranged from 100 to 315 min. Incision length for the single-port device was 2 cm. In Case 2, an additional 5-mm port was used and an intraoperative complication involving a laceration of the liver occurred during the suturing of the gallbladder fundus. An additional 8-cm lower abdominal incision (Pfannenstiel) was required in Case 4 to complete the colonic anastomosis and for specimen retrieval. Single-port endo-laparoscopic surgery is a feasible and safe technique for approaching double procedures. It drastically reduces the number of scars that a double procedure creates, and if difficulty arises, another port can always be added to ease the operation. It can also potentially reduce the number of admissions and anesthesia that a patient undergoes.
authors.affiliation: Department of Surgery, National University Health System, 5 Lower Kent Ridge Road, Singapore.
authors.forename: Guowei
authors.initials: G
authors.lastname: Kim
authors.forename: Davide
authors.initials: D
authors.lastname: Lomanto
authors.forename: Michael M
authors.initials: MM
authors.lastname: Lawenko
authors.forename: Javier
authors.initials: J
authors.lastname: Lopez-Gutierrez
authors.forename: Alembert
authors.initials: A
authors.lastname: Lee-Ong
authors.forename: Shridhar Ganpathi
authors.initials: SG
authors.lastname: Iyer
authors.forename: Wei Keat
authors.initials: WK
authors.lastname: Cheah
authors.forename: Jimmy Bok Yan
authors.initials: JB
authors.lastname: So
authors.forename: Charles Bih Shiou
authors.initials: CB
authors.lastname: Tsang
authors.forename: Yoke Fai
authors.initials: YF
authors.lastname: Fong
mesh_terms: D000307:Adrenal Gland Diseases / Q000150:complications / Q000473:pathology / Q000601:surgery; D000315:Adrenalectomy; D000368:Aged; D013505:Digestive System Surgical Procedures; D005240:Feasibility Studies; D005260:Female; D005705:Gallbladder Diseases / Q000150:complications / Q000473:pathology / Q000601:surgery; D005770:Gastrointestinal Neoplasms / Q000150:complications / Q000473:pathology / Q000601:surgery*; D046449:Hernia, Abdominal / Q000150:complications / Q000473:pathology / Q000601:surgery*; D006801:Humans; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D010048:Ovarian Cysts / Q000150:complications / Q000473:pathology / Q000601:surgery; D010052:Ovariectomy; D016896:Treatment Outcome
keywords: Combined abdominal procedures; laparoscopy; single port