Single port laparoscopic right colonic resection using a 'vessel-first' approach

Aim Single port laparoscopic colorectal surgery (SPLC), performed through a single incision of ≤ 3 cm, has been shown to be feasible. This study aimed to assess its safety and efficacy when used as the method of choice for right hemicolectomy. Method A prospective study was carried out of patients undergoing right hemicolectomy using a single port laparoscopic technique. They were compared with a historical series of patients undergoing right hemicolectomy using a multiport laparoscopic technique. Between December 2009 and September 2010, single port surgery replaced conventional laparoscopic colorectal surgery (LCS) for radical medial to lateral right hemicolectomy performed by a single surgeon. Histology, length of hospital stay, complications, conversions and readmissions were recorded. Results Fourteen patients were treated using single port laparoscopic surgery (SPLC): 10 for carcinoma (Dukes A1, B6, C3) and four for Crohn’s disease. Twelve patients were treated using multiport laparoscopic colorectal surgery (LCS): eight for carcinoma (Dukes B4, C3, Carcinoid 1), three for Crohn’s disease and one for adenoma. The median (interquartile range) operative time for the SPLC group was 120 (90–135) min and for the LCS group was 135 (116–150) min. The median (interquartile range) length of hospital stay was 3.5 (2.0–5.0) days for the SPLC group and for the LCS group was 4.0 (3.8–7.0) days. The median (interquartile range) number of lymph nodes removed for SPLC patients was 14.5 (9.8–19.5) and for the LCS patients was 14.5 (13.0–19.5). There were no conversions, no complications and no readmissions in either group. Conclusion These data confirm the feasibility of the technique. Furthermore they suggest that it is safe and efficacious.