title: Rational manipulation of the standard laparoscopic instruments for single-incision laparoscopic right colectomy.
abstract: This report clarifies the rational manipulation of standard laparoscopic instruments for single-incision laparoscopic right colectomy (SILRC) using the SILS Port. We classified the manipulations required into 4 techniques. Vertical manipulation was required for medial-to-lateral retroperitoneal dissection. Frontal manipulation was needed for extension and establishment of a retroperitoneal plane. External crossing manipulation was used for dissection or ligation of the ileocolic or right colic vessels. Internal crossing manipulation was required for mobilization from the cecum to ascending colon. We performed SILRC for a series of 30 consecutive patients. One additional port was needed in 5 of the patients (16.7%) because of severe adhesion between the ileum and abdominal wall. No intraoperative complications were encountered. Four rational manipulations of the standard laparoscopic instruments are required for SILRC using the SILS Port. However, more experience and comparative trials are needed to determine the exact role of SILRC.
authors: Department of Gastroenterological & General Surgery, Showa University School of Medicine, Tokyo, Japan.
authors: Makoto
authors: M
authors: Watanabe
authors: Masahiko
authors: M
authors: Murakami
authors: Takashi
authors: T
authors: Kato
authors: Toru
authors: T
authors: Onaka
authors: Takeshi
authors: T
authors: Aoki
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016063:Blood Loss, Surgical; D003082:Colectomy / Q000295:instrumentation / Q000379:methods*; D003110:Colonic Neoplasms / Q000601:surgery*; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000295:instrumentation* / Q000379:methods*; D008197:Lymph Node Excision; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D016896:Treatment Outcome
references: Br J Surg. 2010 Jul;97(7):1007-12
references: 20632264
references: Int J Colorectal Dis. 2008 Oct;23(10):1013-6
references: 18607608
references: J Gastrointest Surg. 2010 May;14(5):759-67
references: 20155330
references: Surg Endosc. 2010 Oct;24(10):2613-6
references: 20364353
references: Dis Colon Rectum. 2010 Nov;53(11):1467-72
references: 20940593
references: Tech Coloproctol. 2010 Sep;14(3):225-8
references: 20589521
references: Surg Endosc. 2010 Aug;24(8):1842-8
references: 20174950
references: Surg Endosc. 2009 Jul;23(7):1419-27
references: 19347400
references: Surg Laparosc Endosc Percutan Tech. 2010 Aug;20(4):191-204
references: 20729685
references: World J Gastroenterol. 2010 Jan 14;16(2):275-8
references: 20066750