Single-incision laparoscopic ileocecal resection using an organ retractor

Highlights • SILS is one of the approaches to scarless surgery. • SILS technique is not easy because of the restricted movement and requires a long learning curve. • An organ retractor is effective for SILS not only to maintain a good operative view, but also to shorten the learning curve.
Introduction Single-incision laparoscopic surgery has been reported to be a safe and feasible technique for colorectal cancer. However, the technique needs skill due to the limitations of the device. An organ retractor is a new grasp device that has the potential to overcome these limitations. Presentation of case A 63-year-old woman with a tumor palpated in the right lower quadrant of the abdomen presented to hospital. Colonoscopy showed a type 2 mass with nearly complete stenosis, and a biopsy specimen showed well-differentiated adenocarcinoma. Single-incision laparoscopic surgery ileocecal resection was performed using an organ retractor. A 3-cm incision was placed in the umbilicus, and three conventional ports were inserted. An organ retractor was used for hepatocolic ligament resection, resection of the ileocolic vessels, and resection of the insertion of the mesentery proper. For each resection, the trailer line’s tension was adjusted to provide a good operative view. The patient’s postoperative course was good, and she was discharged 7 days after surgery. Discussion An organ retractor was effective for single-incision laparoscopic surgery technique not only to maintain a good operative view, but also to change trailer line tension, which enabled safe dissection. Conclusion An organ retractor could facilitate single-incision laparoscopic surgery.