Single port laparoscopic surgery for patients with complex and recurrent Crohn's disease

Moftah, Mohamed; Nazour, Fady; Cunningham, M.; Ra, Chisei

doi:10.1016/j.crohns.2014.02.003

Cited by 28 publications

(15 citation statements)

References 26 publications

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“…The glove's fingers are used for instrument and camera access. 29 This approach is simple, inexpensive, and easily reproducible. Furthermore, the flexible character of the finger extensions reduces the trocar conflict routinely experienced during SILS.…”

Section: Technical Considerations Access Platformsmentioning

confidence: 99%

“…[16][17][18] Studies have proven that single-incision laparoscopic surgery (SILS) is safe and feasible for both benign and malignant colorectal disease. [19][20][21][22][23][24][25][26][27][28][29] SILS has demonstrated similar outcomes to traditional laparoscopy. 28,30 Furthermore, using a single umbilical single port with multiple incorporated working channels, SILS has reduced the number of incisions and tissue trauma required for surgery, reduced perioperative pain and narcotic use, improved cosmesis, and lowered the rate of port site-related complications.…”

mentioning

confidence: 91%

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Single-Incision Laparoscopic Colon and Rectal Surgery

Keller

Haas

2015

Clinics in Colon and Rectal Surgery

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Single-incision laparoscopic surgery (SILS) was introduced to further the enhanced outcomes of multiport laparoscopy. Multiple studies have demonstrated the safety and feasibility of SILS for both benign and malignant colorectal disease. SILS provides the potential for improved cosmesis, postoperative outcomes, and patient quality of life. However, widespread use has been limited by technical demands and lack of an evidence and competency-based curriculum.

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Section: Technical Considerations Access Platformsmentioning

confidence: 99%

mentioning

confidence: 91%

Single-Incision Laparoscopic Colon and Rectal Surgery

Keller

Haas

2015

Clinics in Colon and Rectal Surgery

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“…This can sometimes even be performed with a single-port approach [18]. Wu et al [19] assessed the operative outcomes of patients undergoing laparoscopic ileocolonic resection for penetrating CD compared to uncomplicated CD.…”

Section: Combined Surgical Resection With Drainage or Percutaneous Drmentioning

confidence: 99%

Abdominal Abscess in Crohn's Disease: Multidisciplinary Management

Groof

Carbonnel

Buskens

et al. 2014

Dig Dis

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Crohn's disease (CD) is characterized by full-thickness inflammation of the bowel. For this reason, perforating complications such as intra-abdominal abscesses or fistulas are common. A concomitant intra-abdominal abscess with active CD of the small bowel is a challenging dilemma for gastroenterologists and surgeons. Since there is active and severe disease, this should be treated with immunosuppressive drugs. However, in the presence of an intra-abdominal abscess, immunosuppression can be dangerous. There are several treatment options for intra-abdominal abscesses in CD. Nowadays, the first-line treatment is antibiotic therapy with or without percutaneous drainage. Historically, patients were treated with surgical drainage. With the development of percutaneous drainage, treatment shifted to a more nonsurgical approach. Success rates for percutaneous drainage in the literature vary from 74 to 100%, and it is considered to be a relatively safe procedure. It has been reported that surgery can be avoided after successful percutaneous drainage in a variable number of patients (14-85%). If sepsis is controlled, CD medication should be started to prevent recurrence. It is important to monitor the effect upon CD lesions to avoid further perforating complications. Finally, an undrainable or small abscess can be treated with antibiotics alone, although high recurrence rates have been described with this approach. Patients with a concomitant stenosis, an enterocutaneous fistula or refractory active disease are likely to require surgery. Percutaneous drainage in combination with delayed surgery is useful to improve the patient's condition prior to surgery and is associated with less morbidity, a lower stoma rate and more limited resection. In conclusion, when feasible, percutaneous drainage and antibiotics should be the treatment of choice in patients with an intra-abdominal abscess in CD. If surgery is inevitable, this must be delayed to reduce postoperative septic complications and high stoma rates.

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“…To analyze the feasibility of single port laparoscopy in patients with complicated or recurrent disease, an Irish group has recently investigated their patients that presented either with urgent interventions (n = 15), prior abdominal interventions (n = 8), obstruction (n = 7), intraabdominal mass (n = 6), fistulizing disease (n = 6) or abscess (n = 4). For all indications the operation was initiated using a single port approach [40] . For introduction of the instruments a surgical glove port was used.…”

Section: Single Port Laparoscopic Surgerymentioning

confidence: 99%