Search

Single-incision laparoscopic colectomy (SILC) is one of several promising operation choices. Our previous study demonstrated that SILC with a self-made glove-port system both improves the feasibility of SILC and decreases the cost expense of surgery. Because the incision site for SILC could be made at either the umbilicus or McBurney's point, we are interested in whether the incision site affects the outcomes of patients, which is a less explored topic. The purpose of this study is not only to show the results of SILC with a self-made glove-port system for supporting its feasibility, but also to compare the short-term surgical outcomes between SILC with the incision made at the umbilicus and at McBurney's point.We collected and reviewed the medical records of patients who received SILC with a self-made glove-port system for tumors in the left side of the colon from August 2009 to March 2011. All operations were performed by a single surgeon. Comparisons of the demographic characteristics, perioperative data, and clinical outcomes between umbilical and McBurney's SILCs were performed. Postoperative pain was assessed by a visual analog scale and opiate demand.In total, 61 patients were enrolled in this retrospective study. Five of 48 (10.4%) tumors in the umbilical SILC group and 5 of 13 (38.5%) tumors in the McBurney's SILC group were located below the peritoneal reflection. The tumor location was significantly different between these two groups (P=.015). Patients in the umbilical SILC group had significantly higher frequency of opiate demand than those in the McBurney's SILC group (0.4±0.7 versus 1.4±1.8, respectively; P=.002).This study further provides evidence for supporting the safety and feasibility of SILC in treating colorectal diseases. More important is that McBurney's SILC not only alleviates the patient response to wound pain, but also provides the same site for a diverting enterostomy to avoid creating an additional wound.

The instrument crowding derived from commercially available access devices in single-incision laparoscopic surgery (SILS) is a challenge to overcome. This study was designed to evaluate the short-term surgical outcomes of SILS by applying a self-made device in patients with benign colon diseases.We collected and reviewed the medical records of patients who received SILC by using a self-made glove-port system from March 2007 to July 2012. All operations were performed by a single surgeon. Sixty-four patients (36 males and 28 females) were enrolled for this study. Among them, 15 patients received right-side colon resection, 31 patients received left-side colon resection, and 18 patients received total colectomy.In the analysis of medical records from these groups of patients, we found that there was no significant difference of gender, body mass index, tumor size, incision length, and blood loss among these three groups. Furthermore, no significant difference of the pain scores, average length of hospital stay, and average duration of bowel return was observed among these three groups. However, it was notable that younger age, longer duration of operation, and longer bowel resection were indeed significantly found in the patients undergoing total colectomy. On the other hand, curved instruments were used in 5 (16.1%) of 31 patients with left-side colon resection.A simple self-made glove-port device was proven as a practical method of SILS for colorectal diseases. These findings suggested that single-incision laparoscopic total colectomy provides compatible clinical outcome in the patients with benign colon diseases compared with the other two surgical procedures used in this study.