Hybrid single-incision laparoscopic sigmoidectomy: the effective use of small incision.

AIM

Single-incision laparoscopic colectomy (SILC) often requires steeper Trendelenburg positioning to displace or keep the small intestine away from the operative site. We have developed hybrid SILC in which we make a transumbilical incision to extract the specimen first and utilize a multiflap gate (MFG).

METHODS

MFG was inserted through a 4.0-cm transumbilical incision, and a surgical towel was inserted via MFG and displaced the small intestine away from the operative site. Three 5-mm ports were placed in the converter sheet. Almost all the operative procedures were the same as usual laparoscopic sigmoidectomy. In the course of laparoscopic procedures, whenever we felt stress, we used the techniques of open surgery via MFG.

RESULTS

In 3 patients, the procedure was successfully completed without any complications.

CONCLUSIONS

Our procedure can be easily performed, which enables surgeons to achieve SILC safe and easy compared with conventional technique.