title: Single-access laparoscopic rectal cancer surgery using the glove technique.
abstract: BACKGROUND
  Single-access laparoscopic surgery has been widely adopted in many kinds of surgery including laparoscopic cholecystectomy and laparoscopic colectomy. Performing single-access rectal surgery, however, has technical drawbacks such as instrument collision and endostaple application issues. The glove technique is likely to mitigate these problems.
  
  
  METHODS
  Fourteen patients with anal canal to mid-rectum cancers were recruited and underwent single-access laparoscopic surgery via the glove technique. An incision was made at the paraumbilicus to insert a wound protector with surgical gloves. The operation was medial to lateral and inferior mesenteric artery and inferior mesenteric vein were identified and controlled. Total mesorectal excision was performed while keeping traction and countertraction down to the pelvic floor.
  
  
  RESULTS
  Average operative time was 251.66 min (range, 180-300 min). Hospital stay ranged from 5 to 8 days (median, 7 days). No serious early postoperative surgical problems related to complications were observed. The pathologic results showed good mesorectal capsule grading. The mean lymph node harvest was 14 nodes (range, 7-26 nodes), and the mean wound length was 5 cm (range, 4-6 cm).
  
  
  CONCLUSIONS
  In rectal surgery, the glove technique for single-access laparoscopic surgery is feasible and is comparable to commercial single-port techniques in terms of oncologic results.
authors.affiliation: Colorectal Surgery Unit, General Surgery Department, Rajavithi Hospital, College of Medicine, Rangsit University, Bangkok, Thailand.
authors.forename: Siripong
authors.initials: S
authors.lastname: Sirikurnpiboon
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001005:Anus Neoplasms / Q000601:surgery; D005240:Feasibility Studies; D005260:Female; D005932:Gloves, Surgical; D006801:Humans; D007431:Intraoperative Complications / Q000517:prevention & control; D010535:Laparoscopy / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D012004:Rectal Neoplasms / Q000473:pathology / Q000601:surgery*; D016896:Treatment Outcome; D055815:Young Adult
keywords: Laparoscopic rectum cancer surgery; laparoscopic single access-surgery; laparoscopic single-port surgery