Single-incision laparoscopic total colectomy using an organ retractor: A case report

Ishimaru, Kazuhide; Tominaga, Tetsuro; Nonaka, Takashi; Hisanaga, Makoto; Fukuda, Akiko; Yoshimoto, Takafumi; Takei, Daiki; Hidaka, Shigekazu; Sawai, Terumitsu; Nagayasu, Takeshi

doi:10.1016/j.amsu.2020.04.032

Cited by 2 publications

(2 citation statements)

References 27 publications

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“…In all 17 cases of sigmoid or rectosigmoid cancer for which we performed RPS and incorporated the FJ Clip-marionette technique, we were able to perform the operation in almost the same way as in conventional laparoscopic surgery. In a PubMed search, we found two reports of use of an organ retractor during RPS performed for colon cancer (9,10). There are no reports, however, of use of a clip-type assistive device and of altering the direction of the traction during RPS performed for colon cancer.…”

Section: Discussionmentioning

confidence: 99%

Use of the FJ Clip for application of the marionette technique in reduced-port surgery performed for sigmoid or rectosigmoid cancer

Hirasaki¹,

Yoshiba²,

Doi³

et al. 2022

AME Surg J

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Background:We have devised a technique by which we establish the operative field and apply countertraction during performance of reduced-port surgery for sigmoid colon cancer or rectosigmoid colon cancer. The technique was devised to overcome the limitations of reduced-port surgery (RPS) and singleincision laparoscopic surgery (SILS). We applied the technique in 17 patients treated between March 2019 and April 2020.Methods: Three ports were used in all cases, a 12-mm port inserted via the umbilical fossa, a 5-mm port inserted in the right upper abdomen, and a 5-mm port inserted in the right upper lower abdomen. We used a free jaw (FJ) Clip with two pull threads to apply traction from the left upper and left lower abdominal walls (FJ Clip-marionette technique) and to thus supersede the need for assistant forceps. As with the conventional method, the medial to lateral approach was used, the surgery included appropriate lymph node dissection, and a double-stapling anastomosis or functional end-to-end anastomosis was created.Results: Patients began oral intake at a mean of 2.4 days (range, 2-3 days), and mean postoperative hospital stay was 10.3 days (range, 9-15 days). The mean number of lymph nodes retrieved was 17, with lymph node metastasis being identified in 2 patients on histopathologic examination. The mean proximal resection margin was 94.9 mm, and the mean distal resection margin was 58.5 mm. There were no postoperative complications, and there has been only 1 recurrence to date, befalling the patient with stage IV disease.Conclusions: SILS and RPS require surgical field deployment and peeling and dissection by the surgeon alone, but countertraction and the visual field are often insufficient. Use of the FJ Clip-marionette technique allows for countertraction to be maintained and a good view of the operative field. It provides for a procedure close to that of multiport surgery but without the need for an assistant surgeon.

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Section: Discussionmentioning

confidence: 99%

Use of the FJ Clip for application of the marionette technique in reduced-port surgery performed for sigmoid or rectosigmoid cancer

Hirasaki¹,

Yoshiba²,

Doi³

et al. 2022

AME Surg J

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“…Basically, we have to select safer procedures such as conventional laparoscopic surgery or SILS plus one port surgery when the tumor shows malignant potential. We previously performed SILS using an organ retractor to overcome the restrictions related to single-port surgery ( 18 ). This instrument can grasp and release in various positions to provide an adequate view, which could be instructive for non-expert surgeons when considering how to create a better surgical view, as in the case of SILS with an additional port.…”

Section: Discussionmentioning

confidence: 99%

Epidermoid cyst of the cecum resected by single-incision laparoscopic colectomy: a case report

et al. 2021

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Background Epidermoid cyst arising from the cecum is extremely rare. Single-incision laparoscopic surgery is the latest innovation in minimally invasive surgery, and shortens incisions, improves cosmesis, and reduces postoperative pain. We report here the first description of a patient with epidermoid cyst of the cecum treated by ileocecal resection by single-incision laparoscopic surgery. Case presentation A 20-year-old woman presented to our hospital with abdominal pain in the right lower quadrant. Abdominal contrast-enhanced computed tomography showed a 56 × 35-mm cystic mass in the ileocecal area. Magnetic resonance imaging revealed a 56 × 43-mm, T1-hypointense, T2-hyperintense mass attached to the cecum. Gastrointestinal tumor or duplication cyst was suspected, and ileocecal resection was performed using single-incision laparoscopic surgery. Intraoperative examination showed the tumor as a round, whitish mass arising from the cecum. Operation time was 162 min, and intraoperative blood loss was 10 ml. Macroscopic examination showed a 56 × 45-mm elastic-hard, whitish, round mass arising from the cecal wall. Microscopic examination revealed the cyst wall lined by keratinized stratified squamous epithelium. No malignant findings were identified. The final diagnosis was epidermoid cyst of the cecum. The postoperative course was uneventful and she was discharged on postoperative day 5. Conclusions A rare case of cecal epidermoid cyst is reported. Single-incision laparoscopic colectomy using an organ retractor represents a promising option for treating cecal epidermoid cyst.

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Single-incision laparoscopic total colectomy using an organ retractor: A case report

Cited by 2 publications

References 27 publications

Use of the FJ Clip for application of the marionette technique in reduced-port surgery performed for sigmoid or rectosigmoid cancer

Use of the FJ Clip for application of the marionette technique in reduced-port surgery performed for sigmoid or rectosigmoid cancer

Epidermoid cyst of the cecum resected by single-incision laparoscopic colectomy: a case report

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