Reduced-port surgery for rectal cancer

Abstract

Laparoscopic surgery for rectal cancer has short-term and long-term oncological outcomes similar to those of open surgery. Conventional multiport laparoscopic surgery (CMLS) for rectal cancer requires four or five abdominal incisions for trocars, each of which could lead to complications and/or pain. Single-incision laparoscopic surgery (SILS) would reduce the incidence of such wound-related complications and achieve better cosmetic outcomes relative to CMLS. The potential advantages of SILS are less pain and more rapid recovery than achieved with CMLS. However, SILS is rarely used for rectal cancer because of the high-level technical expertise required. Reduced-port laparoscopic surgery (RPS), which involves one additional port, may bridge the technical gap between CMLS and SILS and has a less steep learning curve. RPS for rectal cancer has a short history, and its usefulness has not yet been fully established. Here, we review the present situation, challenges, and future prospects for RPS for rectal cancer.

Single-Port Colonic Surgery: The Bermuda Experience

“…Single Incision Laparoscopic Surgery (SILS) appears to be safe and effective when compared to multiport laparoscopy (2) but is technically challenging due to the resulting crowding of the laparoscopic instruments (3). Doctors learning this type of surgery reportedly have a steep learning curve, and longer operative times can lead to increased surgeon fatigue (4).…”

Preface of the special issue on "A bespoke approach to rectal cancer resection and management"

“…Ishida et al [6] recognise the difficulty associated with learning reduce port surgery, though again note that this technique once mastered may yield benefits in terms reduced operating time over single incision laparoscopic surgery, particularly with advancements in needlescopic surgery.…”