Department of Abdominal Surgery, Jessa Hospital, Hasselt, Belgium.
Colorectal Dis. 2012 Nov;14(11):e764-70. doi: 10.1111/j.1463-1318.2012.03175.x.
Single-incision laparoscopy is a rapidly evolving technique in the spectrum 'standard laparoscopy-natural orifice transluminal endoscopic surgery (NOTES)'. From a commercial perspective, purchase of articulating instruments is advised. However, here we present our early experience with single-incision laparoscopy for right hemicolectomy with standard laparoscopic instrumentation.
Between June 2010 and December 2011, 25 patients presenting with malignant disease underwent single-incision laparoscopy for right hemicolectomy. Four different ports (SILS™ port, Covidien; SSL(®) Access system, Ethicon; X-Cone/S-Portal(®) , Storz; and OCTO™ port, AFS Medical) were used. Patients were recruited prospectively and all data were processed retrospectively.
Twenty-five patients were included in our study (and their characteristics, described later in this paragraph, are expressed as median (range)). Four conversions to standard laparoscopy were performed. The age of patients was 69 (36-89) years, and they had a body mass index (BMI) of 24.5 (19.1-34.2). The duration of surgery was 110 (70-148) min with a healed skin incision length of 35 (20-60) mm. Hospital stay was 5 (2-15) days. In four patients discharge was delayed because of comorbidity. One patient suffered an overwhelming pneumonia.
Single-incision laparoscopy using standard laparoscopic instruments appears to be a safe and feasible technique for malignant disease requiring right hemicolectomy. Randomized, prospective trials are ongoing to prove the benefits of this technique and to compare its oncological outcome measures with those of conventional laparoscopy. In our experience, a low-profile port with a wide intra-abdominal range of motion is most preferable.
单切口腹腔镜技术是“标准腹腔镜-自然腔道内镜手术（NOTES）”技术谱中的一项快速发展的技术。从商业角度来看，建议购买关节器械。然而，在这里我们介绍了我们使用标准腹腔镜器械进行单切口腹腔镜右半结肠切除术的早期经验。
在 2010 年 6 月至 2011 年 12 月期间，25 例患有恶性疾病的患者接受了单切口腹腔镜右半结肠切除术。使用了四种不同的端口（SILS™端口，Covidien；SSL（®）Access 系统，Ethicon；X-Cone/S-Portal（®），STORZ；和 OCTO™端口，AFS Medical）。患者被前瞻性招募，所有数据均被回顾性处理。
我们的研究纳入了 25 例患者（其特征，如稍后在本段落中描述的，以中位数（范围）表示）。有 4 例转为标准腹腔镜。患者年龄为 69（36-89）岁，体重指数（BMI）为 24.5（19.1-34.2）。手术时间为 110（70-148）分钟，切口愈合长度为 35（20-60）毫米。住院时间为 5（2-15）天。有 4 例患者因合并症而延迟出院。有 1 例患者发生了严重的肺炎。
使用标准腹腔镜器械的单切口腹腔镜技术对于需要右半结肠切除术的恶性疾病似乎是一种安全可行的技术。正在进行随机、前瞻性试验，以证明该技术的益处，并将其肿瘤学结果与传统腹腔镜的结果进行比较。根据我们的经验，具有低轮廓和广泛腹腔内运动范围的端口是最优选的。
