Reduced port laparoscopic surgery for colon cancer in a patient with tuberculous kyphosis and dwarfism: a rare case and literature review.

Abstract

With accumulated surgical experience, the contraindications to laparoscopic surgery have been decreasing. Reduced port laparoscopic surgery has been widely adopted for a variety of diseases. However, surgery in patients with anatomic deformities are still a challenge for surgeons, specifically abdominal surgery in patients with severe kyphosis. A 71-year-old man with a diagnosis of ascending colon cancer had severe kyphosis with extremely short stature, secondary to tuberculous spondylitis. Laparoscopic right hemicolectomy was successfully performed with a single umbilical incision plus one port. This is the first reported case involving laparoscopic surgery in a patient with tuberculous kyphosis. The purpose of this report is to describe the surgical skills of reduced port laparoscopic surgery in a patient with altered habitus. With proper planning and a meticulous operation, minimally invasive surgery could be safely achieved.

Laparoscopic resection of retroperitoneal paraganglioma behind the Spiegel lobe in a kyphotic patient: A rare case report

“…Although previous reports have suggested the efficacy of reduced-port surgery for cholecystectomy and colectomy in kyphotic patients (6), it was necessary in this case to completely mobilize the right hepatic lobe to approach the tumor from the left side. It has been established that kyphosis limits multiport placement in tight external spaces when the patient is in the supine position.…”

“…It has been established that kyphosis limits multiport placement in tight external spaces when the patient is in the supine position. Although previous reports have suggested the efficacy of reduced‐port surgery for cholecystectomy and colectomy in kyphotic patients , it was necessary in this case to completely mobilize the right hepatic lobe to approach the tumor from the left side. This procedure required optimal port axis and placement.…”

“…Previous reports have demonstrated the efficacy of the laparoscopic approach in managing colorectal and retroperitoneal cancer in kyphotic patients (1)(2)(3)(4)(5)(6)(7). It has been established that kyphosis limits multiport placement in tight external spaces when the patient is in the supine position.…”

Complete Laparoscopic Nephroureterectomy for the Upper Urinary Tract Urothelial Carcinoma in a Female Patient with Severe Senile Kyphosis: An Initial Case Report

“…A literature search of PubMed database between 1990 and 2015 retrieved seven cases of laparoscopic surgery performed in patients with severe kyphosis, all had low-lying costal margins. 2 , 3 The kinds of laparoscopic surgeries were three cholecystectomies, three hemicolectomies, and one sigmoidectomy. 2 In all cases excepting one, the low-lying costal margin divided the operative field, resulting in a narrow working space after pneumoperitoneum was induced.…”

“… 2 , 3 The kinds of laparoscopic surgeries were three cholecystectomies, three hemicolectomies, and one sigmoidectomy. 2 In all cases excepting one, the low-lying costal margin divided the operative field, resulting in a narrow working space after pneumoperitoneum was induced. The narrow abdomen can also cause difficulty in trocar insertion and in some operative procedures.…”