title: Single-incision laparoscopic surgery for colon and rectal cancer: an initial experience with the technique.
abstract: BACKGROUND
  Single-incision laparoscopic surgery seems destined to take its place in the evolution of minimally invasive surgery. Although isolated cases have been reported in the literature, no series has yet been published on the use of this approach to treat colorectal cancer. We describe the surgical technique and perioperative outcomes of this approach in 15 patients diagnosed for colorectal cancer.
  
  
  METHODS
  We have used several devices to gain transumbilical access to the abdominal cavity, usually working with 3 cannulae to insert the instruments. We used a 5 mm endograsper, and articulated rotating (roticulating) endoscissors and endodissector to assist dissection. Vascular control and section of the rectum were performed using roticulating endostaplers. We combined the use of curved and straight instruments as required for each step during surgery. The dissection technique performed was the same as the one we normally use in conventional laparoscopy. Specimens were extracted through the umbilical incision.
  
  
  RESULTS
  The most commonly performed procedure was sigmoidectomy (n=7), followed by high anterior resection of the rectum (n=5). The mean surgical time was 185±44.9 minutes. The mean hospital stay was 6.2±4.7 days. Three cases (20%) were converted to conventional laparoscopy. Surgery was curative in all of the patients.
  
  
  CONCLUSIONS
  Single-access transumbilical laparoscopic surgery is feasible and safe for treating colorectal carcinoma when performed by surgeons with ample experience in laparoscopic colorectal resection. Further studies are needed to determine the advantages and drawbacks of this procedure.
authors.affiliation: Department of Gastrointestinal Surgery, Hospital Universitario de Canarias, La Laguna, Tenerife, Spain.
authors.forename: Iván
authors.initials: I
authors.lastname: Arteaga González
authors.forename: Antonio
authors.initials: A
authors.lastname: Martín Malagón
authors.forename: Sara Gonzalez
authors.initials: SG
authors.lastname: Garcia
authors.forename: Eudaldo M Lopez-Tomassetti
authors.initials: EM
authors.lastname: Fernández
authors.forename: Angel Carrillo
authors.initials: AC
authors.lastname: Pallares
mesh_terms: D012809:Colon, Sigmoid / Q000601:surgery; D015179:Colorectal Neoplasms / Q000601:surgery*; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000295:instrumentation / Q000379:methods*; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000379:methods*; D061646:Operative Time; D012007:Rectum / Q000601:surgery