Single-incision laparoscopic surgery: outcomes from 224 colonic resections performed at a single center using SILS™

Vestweber, Boris; Galetin, Thomas; Lammerting, K; Paul, Claudia; Giehl, J; Straub, É; Kaldowski, B; Alfes, Angelika; Vestweber, Karl-Heinz

doi:10.1007/s00464-012-2454-6

Cited by 69 publications

(36 citation statements)

References 25 publications

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“…Although conventional multiport laparoscopic colectomy (MLC) is less invasive than open colectomy (OC) and results in less postoperative pain [50][51][52], it still requires several Excluding three studies [23,30,33] which did not exactly report on the mean number of harvested LN incisions for port placement as well as a specimen extraction site, many of which are sited separately on the abdominal wall [52][53][54]. Only five studies [55][56][57][58][59] reported less postoperative pain after ML-RH than after O-RH, with the difference being statistically significant in three [55,57,58] of them.…”

Section: Discussionmentioning

confidence: 99%

“…Only three studies [27,28,30] reported on the follow-up period after SIL-RH, which ranged from 30 days in the study from Vestweber et al [30] to 772 days in the study from Velthuis et al [27]. Data regarding cancer recurrence were reported only in the study from Yun et al [28], which demonstrated that during a mean follow-up period of 24.5 ± 6.2 months, only 9.1 % of patients experienced cancer recurrence.…”

Section: Postoperative Outcomesmentioning

confidence: 99%

“…Papaconstantinou et al [18], using a visual analogue scale, measured the mean maximum postoperative pain score, which was 4.7±2.0 and 3.8± 2.1 on the first and second postoperative day, respectively, while on discharge, mean maximum pain score was 1. Lin et al [33] reported a mean pain score of 2.8±0.9 (pain score scale range=1-10), while Vestweber et al [30] demonstrated a mean postoperative pain score of 2 (pain score scale range= 0-10).…”

Section: Postoperative Outcomesmentioning

confidence: 99%

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Single-Incision Laparoscopic Right Hemi-Colectomy: a Systematic Review

Αποστόλου

Orfanos²,

Papalois

et al. 2015

Indian J Surg

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As surgeons became more adept with laparoscopic colon surgery, other less invasive procedures, such as singleincision laparoscopic right hemi-colectomy (SIL-RH), have been applied. The objective of this study was to evaluate the safety of SIL-RH as well as its intraoperative and postoperative outcomes for right-sided colon diseases. A detailed search in PubMed for citations that included SIL-RH from 2000 to 2014 revealed 21 studies fulfilling the criteria of the present review. A total of 684 patients were analyzed. Of the patients, 50.2 % were men. Mean patient age was 64.8 years. Of the patients, 36.1 % had already undergone an abdominal operation before the performance of SIL-RH, while 69 % of the patients underwent SIL-RH for colon cancer. Relatively low rates of overall morbidity (15 %) and mortality (0.75 %) were reported in the included studies. Mean length of postoperative hospital stay (LOS) was 5.5 days. Bowel motility return had a mean value of 2.8 days. Mean number of harvested lymph nodes (LN) was 19.2 LN. All resection margins were tumorfree. SIL-RH was a safe alternative to multiport laparoscopic right hemi-colectomy (ML-RH) in terms of morbidity and mortality, postoperative gastrointestinal function recovery, LOS, as well as oncological radicalness.

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Section: Discussionmentioning

confidence: 99%

Section: Postoperative Outcomesmentioning

confidence: 99%

Section: Postoperative Outcomesmentioning

confidence: 99%

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Single-Incision Laparoscopic Right Hemi-Colectomy: a Systematic Review

Αποστόλου

Orfanos²,

Papalois

et al. 2015

Indian J Surg

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“…We believe the contributing factors for this request are that patients feel safer in the hospital and daily bed costs are low. Mean length of hospital stay varies between 4 to 10 days in some studies (1,3,7,8). Park et al (4) compared this technique with conventional laparoscopic colorectal surgery (C-LCS) and found that blood loss, resection margin length, and morbidity were similar but the operation time in single port surgeries were shorter.…”

Section: Discussionmentioning

confidence: 99%

Single-incision (with multi-input single-port) laparoscopic colorectal procedures: Early results

Ertem

Gök

Özveri

2013

UCD

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Objective: Single incision laparoscopic surgery (SILS) is a "scar-less" new surgical technique which has been gaining popularity over recent years. In comparison to conventional multiport laparoscopic surgery, SILS is introduced as a less invasive method. This technique has also been applied to colorectal surgery. The aim of the presenting study is to investigate the applicability of SILS and report short term results. Material and Methods:We evaluated prospectively collected data of 24 patients who had been operated with "Single Incision Laparoscopic Colon Resection (SILCR)" in our clinic between June 2011-June 2013. Informed consent was obtained from all patients before surgery. Patient data such as ASA and BMI values, need for additional surgery, tumors, number of lymph nodes resected, length of hospital stay, length of surgery, timing of flatus, time to start oral feeding and complications were recorded.Results: SILCR was performed in 24 patients. In 13 patients, SILCR was performed for cancer treatment. There was no need for extra ports, conversion to open surgery and stoma creation was also not necessary. Drain was placed in 4 patients. Overall complication rate was 12.5%. The mean number of lymph nodes in 13 patients who underwent SILCR for tumor was found to be 23 (14-33). The mean operative time and length of hospital stay was 177 minutes (110-363) and 5.35 days (4-11) respectively. Anastomotic leakage was not seen in any of the patients. In one patient, urinoma formation due to ureteral leakage was seen which resulted from thermal injury. Conclusion:When we compare other series with almost the same number of patients' reported SILS results in the literature, we believe that we could draw conclusions from our data. SILS appears to have comparable results to conventional multiport laparoscopic surgery in the hands of experienced surgeons. It seems advantegous as it can be done with conventional laparoscopic instruments in a "scar-less" manner. Prospective randomized trials are necessary to define the benefits of one procedure over the other. Original Investigation INTRODUCTIONExpertise in laparoscopy over 20 years and the advances in technology expand the role of NOTES and single port or single incision surgeries within the spectrum of minimally invasive surgery. This technique has rapidly gained acceptance with support from flexible hand devices, telescopes with rotating ends and port systems that can be placed through 2-5 cm incisions without gas leakage. This technique was first used in right-hemicolectomy by Remzi et al. for a large cecal polyp (1). Similar to the way laparoscopic surgery began; single incision surgery was first used in cholecystectomy and gained popularity thereafter. Colorectal procedures with this method have also begun during the same period. According to results from studies on single incision surgical procedures, this method has a slight advantage over conventional laparoscopic procedures with less pain, less length of hospital stay and faster recovery (2-4).

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“…In fact, sigmoidectomy is the most frequent procedure performed for benign left-side pathology, predominantly diverticular disease or large colonic polyps not suitable for endoscopic removal. Recently, Vestweber et al [61] have reported the largest series of patients undergoing single-incision colorectal surgery in a single institution. One hundred and fifty out of 244 procedures were sigmoidectmy (n = 145) with left hemicolectomies (n = 4) and high anterior resection of the rectum (n = 1).…”

Section: Feasibility and Safety Of Single-incision Colectomymentioning

confidence: 99%

Single-Incision Laparoscopic Colectomy: A New Era in the Treatment of Colorectal Cancer?

Cianchi¹,

Staderini²,

Badii³

2014

Colorectal Cancer - Surgery, Diagnostics and Treatment

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Single-incision laparoscopic surgery: outcomes from 224 colonic resections performed at a single center using SILS™

Abstract: Our findings support the feasibility and tolerability of colorectal surgery, conducted by experienced laparoscopic surgeons without specific training in use of the SILS port.

Cited by 69 publications

References 25 publications

Single-Incision Laparoscopic Right Hemi-Colectomy: a Systematic Review

Single-Incision Laparoscopic Right Hemi-Colectomy: a Systematic Review

Single-incision (with multi-input single-port) laparoscopic colorectal procedures: Early results

Single-Incision Laparoscopic Colectomy: A New Era in the Treatment of Colorectal Cancer?

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