Micro-laparoscopic colectomy: initial experience.
BACKGROUND
Single-port surgery (SPS) has been growing in acceptance as an alternative to traditional laparoscopic surgery. With SPS, there are technical skills required that are not routine to standard laparoscopy. We explored the feasibility of micro-laparoscopic colectomy (MLC) using 3 mm instruments in patients eligible for standard laparoscopic surgery.


METHODS
We performed an IRB approved retrospective review of all segmental colectomy performed by a single surgeon in selected patients using a micro-laparoscopic technique. We utilized two 3-mm trocars and one 12-mm Hasson umbilical incision, which was later widen for specimen extraction.


RESULTS
Eighty patients underwent MLC: Twenty-six for diverticulitis, 26 for cancer, 22 for polyps, 3 for Crohn's disease, and 3 for volvulus. Eight patients were converted into either laparotomy or hand port (10 %) and three patients required the addition of one 5-mm trocar. Mean final extraction incision length was 3.9 cm. In cancer patients, the average lymph node harvest was 26 (range 13-70). The 30-day mortality was zero and the anastomotic leak rate was 1.3 %.


CONCLUSIONS
MLC is safe and feasible when performing colon resections for benign and oncologic pathology. Extraction incision length is small and offers similar cosmesis to SPS without the steep learning curve needed to learn this technique.
Department of Surgery, New York Hospital Queens, 56-45 Main Street, Suite W-LL300, Flushing, NY, 11355, USA, cmf2004@nyp.org.
Christopher M
CM
Foglia
Stuart
S
Blackwood
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D057868:Anastomotic Leak / Q000209:etiology; D003082:Colectomy / Q000009:adverse effects / Q000295:instrumentation* / Q000379:methods; D003110:Colonic Neoplasms / Q000601:surgery*; D003111:Colonic Polyps / Q000601:surgery; D003424:Crohn Disease / Q000601:surgery; D004238:Diverticulitis / Q000601:surgery*; D005260:Female; D006801:Humans; D045822:Intestinal Volvulus / Q000601:surgery; D010535:Laparoscopy / Q000009:adverse effects / Q000295:instrumentation* / Q000379:methods; D059032:Learning Curve; D008197:Lymph Node Excision / Q000295:instrumentation* / Q000379:methods; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D055815:Young Adult