Kawahara Hidejiro, Watanabe Kazuhiro, Tomoda Mitsuhiro, Enomoto Hiroya, Akiba Tadashi, Yanaga Katsuhiko
Hepatogastroenterology. 2014 Oct;61(135):1954-6.
BACKGROUND/AIMS: Although single incision laparoscopy surgery (SILS) has recently been applied to various kinds of disease, there are few reports on partial transverse colectomy by SILS. We have been performing SILS plus one port procedure, SILS plus One.
After placing 3cm incision in the umbilical fossa, a SILS portTM was introduced, and a 5-mm port was inserted in the upper left quadrant of the abdomen, and laparoscopic procedure was started. After the greater omentum was divided, inferior margin of the pancreas was dissected in order to detect the gastrocolic trunk and root of the middle colic artery and vein. After a small mesocolon window was created near the root of middle colic artery, the middle colic artery and vein as well as accessory right colic vein were divided at their root. Both oral and anal margin of the mesocolon were incised by LigaSure™. The surgical specimen was extracted through the umbilical wound and intestinal anastomosis was performed manually using absorbent sutures.
Between 2010 and 2012, six consecutive early transverse colon cancer patients including three male underwent this procedure. The mean operative time was 165.0 (range = 150-180) min, the mean operative blood loss was 7.5 (range = 0-30) ml, the mean hospitalization after surgery was 10.5 (range = 10-12) days, and postoperative complications were not encountered.
SILS plus One for partial transverse colectomy is feasible and safe.
背景/目的：尽管单切口腹腔镜手术（SILS）近来已应用于多种疾病，但关于SILS行部分横结肠切除术的报道较少。我们一直在开展SILS加单孔操作，即SILS加单孔手术。
在脐窝做一个3cm的切口，置入一个SILS端口，在左上腹插入一个5mm的端口，然后开始腹腔镜手术。分离大网膜后，解剖胰腺下缘以找到胃结肠干及中结肠动静脉根部。在中结肠动脉根部附近创建一个小的结肠系膜窗口后，在根部切断中结肠动静脉及副右结肠静脉。用LigaSure™切断结肠系膜的远近端边缘。手术标本经脐部伤口取出，用可吸收缝线手工进行肠吻合。
2010年至2012年期间，连续6例早期横结肠癌患者（包括3例男性）接受了该手术。平均手术时间为165.0（范围=150 - 180）分钟，平均术中失血量为7.5（范围=0 - 30）毫升，术后平均住院时间为10.5（范围=10 - 12）天，未出现术后并发症。
SILS加单孔用于部分横结肠切除术是可行且安全的。
