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Single-incision laparoscopic surgery: outcomes from 224 colonic resections performed at a single center using SILS™.
- Source :
- Surgical Endoscopy & Other Interventional Techniques; Feb2013, Vol. 27 Issue 2, p434-442, 9p, 4 Charts, 1 Graph
- Publication Year :
- 2013
-
Abstract
- Background: Compared with single-incision laparoscopy, multiport laparoscopy is associated with greater risk of postoperative wound pain, infection, incisional hernias, and suboptimal cosmetic outcomes. The feasibility of minimally invasive single-incision laparoscopic surgery (SILS) for colorectal procedures is well-established, but outcome data remain limited. Methods: Patients with benign diverticular disease, Crohn's disease, or ulcerative colitis admitted to Klinikum Leverkusen, Germany, for colonic resection between July 2009 and March 2011 ( n = 224) underwent single-incision laparoscopic surgery using the SILS™ port system. Surgeons had ≥7 years' experience in laparoscopic colon surgery but no SILS™ experience. Patient demographic and clinical data were collected prospectively. Pain was evaluated by using a visual analog scale (0-10). Data were analyzed by using the SPSS PASW Statistics 18 database. Results: The majority of patients underwent sigmoid colectomy with high anterior resection (AR) or left hemicolectomy ( n = 150) for diverticulitis. Our conversion rate to open surgery was 6.3 %, half in patients undergoing sigmoid colectomy with high AR or left hemicolectomy, 95 % of whom had diverticulitis. Mean operating time was 166 ± 74 (range, 40-441) min in the overall population, with shorter times for single-port transanal tumor resection (SPTTR; 89 ± 51 min; range, 40-153 min) and longer times for proctocolectomy (325 min; range, 110-441 min). Mean hospital stay was approximately 10 days, longer after abdominoperineal rectal resection or proctocolectomy (12-16 days). Most complications occurred following sigmoid colectomy with high AR or left hemicolectomy [19/25 (76 %) of early and 4/5 (80 %) of late complications, respectively]. Pain was <4 on a scale of 0-10 in all cases on postoperative day 1, and typically decreased during the next 2 days. Conclusions: Our findings support the feasibility and tolerability of colorectal surgery, conducted by experienced laparoscopic surgeons without specific training in use of the SILS™ port. [ABSTRACT FROM AUTHOR]
Details
- Language :
- English
- ISSN :
- 18666817
- Volume :
- 27
- Issue :
- 2
- Database :
- Complementary Index
- Journal :
- Surgical Endoscopy & Other Interventional Techniques
- Publication Type :
- Academic Journal
- Accession number :
- 85716364
- Full Text :
- https://doi.org/10.1007/s00464-012-2454-6