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Single-access laparoscopic colectomy utilizing gravity in the lateral decubitus position.
MedLine Citation:
PMID:  23135589     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
BACKGROUND: : Only a limited number of instruments can be used in single-access laparoscopic colectomy, and triangulation must be forfeited to avoid instrument collision. We investigated whether this problem could be overcome by performing laparoscopic colectomy by the use of the lateral decubitus position, making full use of gravity.
OBJECTIVE: : The aim of this study was to determine whether single-access laparoscopic colectomy could be achieved while maintaining patients in the lateral decubitus position.
DESIGN: : This was a prospective study.
SETTING: : This single-center study was conducted in a hospital.
PATIENTS: : Ten consecutive patients (4 men and 6 women) with stage II or III colon cancer were included.
INTERVENTIONS: : Each patient was placed in the lateral decubitus position. Single-port access to the abdomen was provided by a 3.0-cm incision at the umbilicus. The roots of the supplying or draining vessels were isolated and divided for lymphadenectomy. Next, the colon was dissected from a lateral approach, without the help of the assistant. The specimen was extracted from the single-access incision. Extracorporeal or intracorporeal anastomosis was performed.
MAIN OUTCOME MEASURES: : The primary outcome measured was the feasibility of single-access laparoscopic colectomy in the lateral decubitus position.
RESULTS: : There were no intraoperative complications and no need for conversions to conventional laparoscopic surgery, open surgery, or the supine position. The median total surgical time was 154 minutes (interquartile range, 135-220 minutes). Surgical blood loss was slight (<20 mL) in all patients. No postoperative complications occurred. The median postoperative hospital stay was 7 days (interquartile range, 5-7 days).
LIMITATIONS: : The sample size was small.
CONCLUSIONS: : Our results show that single-access laparoscopic colectomy in the lateral decubitus position is safe and feasible.
Authors:
Dai Uematsu; Gaku Akiyama; Akiko Magishi; Hirokazu Komatsu; Takayuki Sano
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Diseases of the colon and rectum     Volume:  55     ISSN:  1530-0358     ISO Abbreviation:  Dis. Colon Rectum     Publication Date:  2012 Dec 
Date Detail:
Created Date:  2012-11-08     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0372764     Medline TA:  Dis Colon Rectum     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1295-9     Citation Subset:  IM    
Affiliation:
1 Department of Digestive Surgery, Saku Central Hospital, Saku-City, Nagano, Japan 2 Department of Digestive Surgery, Saitama Cooperative Hospital, Kawaguchi-City, Saitama, Japan.
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