Pignata G, Bracale U, Mijatovic S, Perna F, Lazzara F, Badessi F
General and Mini-Invasive Surgery, "San Camillo" Hospital, Trento, Italy.
Acta Chir Iugosl. 2012;59(2):71-4. doi: 10.2298/aci1202071p.
To minimize the complications related to conventional multiport laparoscopic surgery, the single access laparoscopic surgery has been developed. Some results of case series and case-controlled studies are supporting the feasibility and safety of Single Access Laparoscopic Colectomy (SALC).
Since January 2009 we performed all kind of colorectal procedure by a single access laparoscopic approach. We began with right colectomy that represent the only procedure in which we did not reproduce the same surgical steps of multiport laparoscopic surgery. In contrast, we reproduce the same surgical technique of multiport colorectal resection during a left or rectal single access laparoscopic procedure as well as total colectomy.
About the transferability of SALC, programs of training need to focus on safety and techniques. We believe that only high laparoscopic skills surgeon can perform SALC. It's mandatory to evaluate outcomes and cost-effectiveness of SALC respect to multiport laparoscopic colectomy using randomized trials.
为了将传统多端口腹腔镜手术相关的并发症降至最低，单孔腹腔镜手术应运而生。一些病例系列研究和病例对照研究的结果支持了单孔腹腔镜结肠切除术（SALC）的可行性和安全性。
自2009年1月起，我们采用单孔腹腔镜入路进行所有类型的结直肠手术。我们从右半结肠切除术开始，这是唯一一种我们没有重复多端口腹腔镜手术相同手术步骤的手术。相比之下，在左半结肠或直肠单孔腹腔镜手术以及全结肠切除术中，我们采用了与多端口结直肠切除术相同的手术技术。
关于SALC的可推广性，培训计划需要侧重于安全性和技术。我们认为只有具备高腹腔镜技能的外科医生才能实施SALC。必须通过随机试验评估SALC相对于多端口腹腔镜结肠切除术的疗效和成本效益。
