The single-incision laparoscopic surgery technique has questionable advantages in colorectal surgery

AbstractBackground:Laparoscopic procedures have increasingly been accepted as standard in surgical treatment of benign and malignant entities, resulting in a continuous evolution of operative techniques. Since one of the aims in laparoscopic colorectal surgery is to reduce access trauma, one possible way is to further reduce the surgical site by the single-incision laparoscopic surgery technique (SLS). One of the main criticisms concerning the use of SLS is its questionable benefit combined with its technical demands for the surgeon. These questions were addressed by comparing SLS versus conventional laparoscopic multitrocar surgery (LMS) in benign and malignant conditions with respect to technical operative parameters and early postoperative outcome of the patients.Methods:Between 2010 and 2013, we performed SLS for colorectal disease. Of the 111 patients who underwent colorectal resection, 47 patients were operated by SLS and 31 using the LMS technique. The collected data for our patients were compared according to operating time, postoperative morbidity and mortality, pain score numeric rating scale on day 1 and day 5 postoperatively and postoperative hospital stay. To complement the pain scores, the required pain medication for adequate pain relief on these days was given.Results:There was no significant difference in age, BMI or sex ratio between the two groups. The intraoperative and early postoperative course was comparable as well. Postoperative hospital stay was the only parameter with a significant difference, showing an advantage for SLS.Conclusion:SLS is a feasible surgical method and a technical option in laparoscopic colorectal surgery. However, we were not able to identify substantial advantages of SLS that would favor this technique.

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Comparative study of single incision versus conventional three port laparoscopic appendectomy

International Surgery Journal ◽

10.18203/2349-2902.isj20184701 ◽

2018 ◽

Vol 5 (12) ◽

pp. 3852 ◽

Cited By ~ 1

Author(s):

Sahil Rometra ◽

Rahil Rometra ◽

Neeraj Koul ◽

R. K. Chrungoo

Keyword(s):

Laparoscopic Surgery ◽

Acute Appendicitis ◽

Hospital Stay ◽

Laparoscopic Appendectomy ◽

Operative Time ◽

Single Incision ◽

Open Appendectomy ◽

Single Incision Laparoscopic Surgery ◽

Abdominal Incision ◽

Significant Difference

Background: Appendicitis is primarily a disease of adolescents and young adults with a peak incidence in the second and third decades of life. Appendectomy for appendicitis is the most commonly performed emergency operation in the world.For more than a century, open appendectomy remained the gold standard for the treatment of acute appendicitis. Laparoscopic surgery has become popular universally during the last couple of decades. Efforts are still being made to decrease abdominal incision and visible scars after laparoscopy. Single incision laparoscopic surgery (SILS) is a new innovation allowing minimal access surgery to be performed through a single umbilical incision.Methods: It was a prospective study carried out on 50 patients diagnosed as acute appendicitis. They were divided into two groups of 25 each. One group underwent Conventional Laparoscopic Appendectomy (CLA) and other group underwent Single Incision Laparoscopic Surgery (SILS). Results were compared with regard to mean operative time, complications, post-operative pain and discomfort (vas score at 12 hours), post-operative morbidity, duration of hospital stay and condition at discharge and cosmesis.Results: There was no statistically significant difference between the two groups with respect to the parameters like postoperative pain, hospital stay and complication profile. However, operative time for SILS appendectomy were found to be significantly higher compared to conventional group.Conclusions: Single incision laparoscopic appendectomy using standard laparoscopic instruments is safe and effective, feasible surgery with better cosmetic results.

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Comparison of Short-Term Outcomes Between Robotic-Assisted and Laparoscopic Surgery in Colorectal Cancer

Surgical Innovation ◽

10.1177/1553350618797822 ◽

2018 ◽

Vol 26 (1) ◽

pp. 57-65 ◽

Cited By ~ 1

Author(s):

Xiao-Long Zhu ◽

Pei-Jing Yan ◽

Liang Yao ◽

Rong Liu ◽

De-Wang Wu ◽

...

Keyword(s):

Colorectal Cancer ◽

Laparoscopic Surgery ◽

Colorectal Surgery ◽

Hospital Stay ◽

Bowel Function ◽

Postoperative Recovery ◽

Postoperative Hospital Stay ◽

Robot Assisted ◽

Short Term ◽

Robotic Colorectal Surgery

Aim. The robotic technique has been established as an alternative approach to laparoscopy in colorectal surgery. The aim of this study was to compare short-term outcomes of robot-assisted and laparoscopic surgery in colorectal cancer. Methods. The cases of robot-assisted or laparoscopic colorectal resection were collected retrospectively between July 2015 and October 2017. We evaluated patient demographics, perioperative characteristics, and pathologic examination. A multivariable linear regression model was used to assess short-term outcomes between robot-assisted and laparoscopic surgery. Short-term outcomes included time to passage of flatus and postoperative hospital stay. Results. A total of 284 patients were included in the study. There were 104 patients in the robotic colorectal surgery (RCS) group and 180 in the laparoscopic colorectal surgery (LCS) group. The mean age was 60.5 ± 10.8 years, and 62.0% of the patients were male. We controlled for confounding factors, and then the multiple linear model regression indicated that the time to passage of flatus in the RCS group was 3.45 days shorter than the LCS group (coefficient = −3.45, 95% confidence interval [CI] = −5.19 to −1.71; P < .001). Additionally, the drainage of tube duration (coefficient = 0.59, 95% CI = 0.3 to 0.87; P < .001) and transfers to the intensive care unit (coefficient = 7.34, 95% CI = 3.17 to 11.5; P = .001) influenced the postoperative hospital stay. The total costs increased by 15501.48 CNY in the RCS group compared with the LCS group ( P = .008). Conclusions. The present study suggests that colorectal cancer robotic surgery was more beneficial to patients because of shorter postoperative recovery time of bowel function and shorter hospital stays.

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Single Incision Laparoscopic Cholecystectomy vs Conventional Cholecystectomy in Developing Country

Journal of Nepal Medical Association ◽

10.31729/jnma.91 ◽

2010 ◽

Vol 49 (179) ◽

Cited By ~ 1

Author(s):

P B Thapa ◽

DK Maharjan ◽

DR Singh

Keyword(s):

Laparoscopic Cholecystectomy ◽

Laparoscopic Surgery ◽

Single Incision ◽

Single Incision Laparoscopic Surgery ◽

Conventional Laparoscopic Cholecystectomy ◽

Conventional Laparoscopic ◽

Level Of Satisfaction ◽

Single Incision Surgery ◽

Significant Difference ◽

Single Incision Laparoscopic Cholecystectomy

INTRODUCTION: Use of laparoscopic surgery has demanded principles of less trauma of access hence less scar and so probably less complications. Hence conventional laparoscopic surgeries were tried with natural orifice transluminal surgery (NOTES) and then single incision laparoscopic surgery (SILS). With refinement in instruments and surgeons skills SILS have bridged up between conventional and NOTES in order to quench the desire of less or no scar at all. METHODS: Comparative case control study between conventional laparoscopic cholecystectomy and SILS in public teaching hospital. RESULTS: Total 20 patients underwent SILS cholecystectomy and 20 underwent conventional cholecystectomy and found that no difference between both in terms of post operative pain score, hospital stay and post operative wound infection except significant difference in mean operative time and patient's level of satisfaction was less in patient with SILC if were subjected to pay for instruments in order to maintain cosmesis. CONCLUSIONS: Though SILS have gained rapid acceptance in surgical fraternity, large number of randomized controlled trials are necessary to show its benefit over conventional laparoscopic cholecystectomy. Keywords: cholecystectomy, conventional, laparoscopy, single incision, surgery

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Review of single incision laparoscopic surgery in colorectal surgery

World Journal of Gastroenterology ◽

10.3748/wjg.v21.i38.10824 ◽

2015 ◽

Vol 21 (38) ◽

pp. 10824 ◽

Cited By ~ 9

Author(s):

Nisreen Madhoun

Keyword(s):

Laparoscopic Surgery ◽

Colorectal Surgery ◽

Single Incision ◽

Single Incision Laparoscopic Surgery

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Gloved Appendectomy Performed With a Gloved Single Incision Laparoscopic Surgery Technique Versus Conventional Multiport Laparoscopic Technique

CRSLS MIS Case Reports from SLS ◽

10.4293/crsls.2014.00316 ◽

2014 ◽

Vol 18 (4) ◽

Author(s):

Bin Chet Toh ◽

Quor Meng Leong

Keyword(s):

Laparoscopic Surgery ◽

Single Incision ◽

Laparoscopic Technique ◽

Single Incision Laparoscopic Surgery ◽

Surgery Technique

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Comparison of clinical outcome of single-incision laparoscopic surgery using a simplified access system with conventional laparoscopic surgery for malignant colorectal disease

Colorectal Disease ◽

10.1111/j.1463-1318.2011.02825.x ◽

2012 ◽

Vol 14 (4) ◽

pp. e171-e176 ◽

Cited By ~ 36

Author(s):

C.-C. Lu ◽

S.-E. Lin ◽

K.-C. Chung ◽

K.-M. Rau

Keyword(s):

Laparoscopic Surgery ◽

Clinical Outcome ◽

Single Incision ◽

Colorectal Disease ◽

Single Incision Laparoscopic Surgery ◽

Conventional Laparoscopic Surgery ◽

Conventional Laparoscopic ◽

Access System

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Single-incision laparoscopic surgery (SILS) for the treatment of ileocolonic Crohn’s disease: a propensity score–matched analysis

International Journal of Colorectal Disease ◽

10.1007/s00384-020-03821-6 ◽

2020 ◽

Author(s):

Valerio Celentano ◽

◽

Gianluca Pellino ◽

Matteo Rottoli ◽

Francesco Colombo ◽

...

Keyword(s):

Crohn’S Disease ◽

Laparoscopic Surgery ◽

Crohn's Disease ◽

Propensity Score ◽

Hospital Stay ◽

Open Surgery ◽

Single Incision ◽

Length Of Hospital Stay ◽

Single Incision Laparoscopic Surgery ◽

Ileocolic Resection

Abstract Introduction Single-incision laparoscopic surgery (SILS) aims to minimize the surgical access trauma by reducing the number of abdominal incisions to a single site, potentially offering better cosmetic results and decreased postoperative pain. In this study, we compare the results of SILS ileocolic resection for Crohn’s disease (CD) to conventional laparoscopy and open surgery using a propensity score–matched analysis in a retrospective national multicentre study. Methods All consecutive patients undergoing elective SILS ileocaecal or redo ileocolic resection for primary and recurrent CD from 1 June 2018 to 31 May 2019 were included. Patients were matched 1:1:1 with laparoscopy and open surgery according to perianal disease, recurrent disease, penetrating phenotype of CD, history of previous abdominal surgery, preoperative medical treatment with steroids and anti-TNF. Postoperative morbidity within 30 days of surgery was the primary endpoint. Results Fifty-eight patients were included in each group, for a total of 174 patients. The conversion rate for SILS and laparoscopy was 10.3% and 12%, respectively, with no difference in the incidence of postoperative complications (13.8% and 12%, p = 0.77), whilst open surgery demonstrated a worse morbidity profile, with a complication rate of 25.9% (p < 0.0001). Median length of hospital stay following SILS ileocolic resection was 5 days, significantly shorter compared to 7 days for laparoscopy and 9 for open surgery (p < 0.0001). Conclusions SILS ileocolonic resection for CD demonstrated a comparable morbidity profile compared to laparoscopy in selected patients, with a reduced length of postoperative hospital stay.

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LAPAROSCOPIC COLORECTAL SURGERY;

The Professional Medical Journal ◽

10.29309/tpmj/2014.21.04.2195 ◽

2018 ◽

Vol 21 (04) ◽

pp. 583-586

Author(s):

Zulfiqar Hanif ◽

Muhammad Attique ◽

Haitham Qandeel ◽

Abdul Latif Khan

Keyword(s):

Colorectal Surgery ◽

Hospital Stay ◽

Laparoscopic Colorectal Surgery ◽

Laparoscopic Group ◽

Open Group ◽

Port Site Recurrence ◽

Long Term Outcome ◽

Significant Difference ◽

Duration Of Surgery ◽

The Mean

Objective: The aim of this study was to assess the outcome of laparoscopiccolorectal procedures performed in a district general hospital within 5 years period and tocompare it with patients who had an open procedure during the same period. Patients andMethods: Data were collected retrospectively from patient’s case notes retrieved from hospitalmedical records. One hundred consecutive cases of laparoscopic colonic resection includingboth benign and malignant diseases between 2005 and 2010 were analysed for perioperativeand long term outcome and were compared with consecutive one hundred cases of opencolectomies. Results: Overall conversion rate was 6% for laparoscopic group. The mean majorcomplication rates in laparoscopic group were 5% (3% in open group) and minor complicationsoccurred in 18% (28% in open group). There was no mortality in either group. The overallmorbidity rate was 23% in laparoscopic group as compared to 31% in open colectomy group. In64 cases, curative laparoscopic resections were performed for colorectal malignancy while 72patients had resections for cancer in open group. The mean lymph node harvest in laparoscopicgroup was 13.2 nodes as compared to 12.4 in open group; no port-site recurrence wasdocumented at a mean follow-up of 26 months. Average duration of surgery was 180 minutes ascompared to 140 minutes in open group. Mean postoperative hospital stay was reduced from 13days to 7 days. (Open Vs. Lap). There was no statistically significant difference in majorcomplication rates and mortality. Conclusions: Laparoscopic colorectal surgery is safe andfeasible in elective colorectal cases and reduces the hospital stay without any added morbidity.

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