SPIRE Bristol Hospital, Bristol, UK.
Colorectal Dis. 2011 Apr;13(4):393-8. doi: 10.1111/j.1463-1318.2009.02158.x.
Single-incision (or port) laparoscopic surgery (SILS) has recently emerged as a method to improve morbidity and cosmetic benefit of conventional laparoscopic surgery. The literature contains two reports of SILS right hemicolectomy, and we report our experience of this technique.
Seven consecutive, unselected patients underwent SILS retrocaecal appendicectomy, right hemicolectomy, extended right hemicolectomy, colectomy with ileorectal anastomosis, proctocolectomy, anterior resection and restorative proctocolectomy/ileoanal pouch using a single Triport (Olympus Keymed, Southend, UK), conventional instrumentation and nerve block analgesia. Three had undergone previous surgery, two had cancer and two were immunosuppressed.
Umbilical, right- and left-iliac fossa SILS was feasible using conventional instruments. Operative time ranged between 23 and 195 min (median 48 min). Four patients tolerated normal diet within 6 h (12-16 h for the remainder). Only one patient required postoperative enteral morphine (10 mg × 4). Discharge occurred between 8 and 90 h (median 16 h) of surgery. A secondary haemorrhage from the ileorectal anastomosis was managed conservatively.
SILS colorectal resection is feasible and safe when performed by an experienced laparoscopic surgeon and theatre team. It may have advantages over conventional laparoscopic surgery in terms of reduced pain, lower cost, faster recovery and cosmesis.
单切口（或端口）腹腔镜手术（SILS）最近作为一种方法出现，旨在提高常规腹腔镜手术的发病率和美容效果。文献中有两份关于 SILS 右半结肠切除术的报告，我们报告了我们对此技术的经验。
连续对 7 名未经选择的患者进行 SILS 盲肠后阑尾切除术、右半结肠切除术、扩大右半结肠切除术、结肠切除术伴回直肠吻合术、直肠结肠切除术、前切除术和直肠重建/回肠肛管吻合术，使用单个 Triport（Olympus Keymed，英国绍森德）、常规器械和神经阻滞镇痛。其中 3 人以前接受过手术，2 人患有癌症，2 人免疫抑制。
使用常规器械可行脐部、右髂窝和左髂窝 SILS。手术时间在 23 至 195 分钟之间（中位数为 48 分钟）。4 名患者在 6 小时内（其余患者为 12-16 小时）耐受正常饮食。只有 1 名患者需要术后肠内吗啡（10mg×4 次）。手术后的出院时间在 8 至 90 小时之间（中位数为 16 小时）。吻合口的二次出血通过保守治疗处理。
当由经验丰富的腹腔镜外科医生和手术室团队进行时，SILS 结直肠切除术是可行且安全的。它可能在减轻疼痛、降低成本、更快恢复和美容方面优于传统腹腔镜手术。
