Umbilical single incisional approach plus one port for partial transverse colectomy: initial operative experience.

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.

SURGICAL PROCEDURE: 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.

RESULTS: 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.

CONCLUSION: SILS plus One for partial transverse colectomy is feasible and safe.