Single incision laparoscopic colectomy: technical aspects, feasibility, and expected benefits

Abstract

Background. This paper studied technical aspects and feasibility of single incision laparoscopic colectomy (SILC). Methods. Bibliographic search was carried out up to October 2009 including original articles, case reports, and technical notes. Assessed criteria were techniques, operative time, scar length, conversion, complications, and hospitalization duration. Results. The review analyzed seventeen SILCs by seven surgical teams. A single port system was used by four teams. No team used the same laparoscope. Two teams used two laparoscopes. All teams used curved instruments. SILC time was 116 +/- 34 minutes. Final scar was longer than port incision (31 +/- 7 versus 24 +/- 8 mm; P = .036). No conversion was reported. The only complication was a bacteremia. Hospitalization was 5 +/- 2 days. Conclusion. SILC is feasible. A single incision around the umbilical scar represents cosmetic progress. Comparative studies are needed to assess potential abdominal wall and recovery benefits to justify the increased cost of SILC.

Figure 1

Single incision laparoscopic colorectal surgery: studies selection.

Figure 2

Single port systems used in the studies selected. (a) SILS Port (Covidien, Norwalk, Connecticut, USA); (b) ASC Triport (Advanced Surgical Concepts, Wicklow, Ireland); (c) Uni-X (Pnavel Systems, Morganville, New Jersey, USA); (d) GelPort (Applied Medical, Rancho Santa Margarita, California, USA).