%0 Journal Article
%T Single-Access Laparoscopic Rectal Surgery Is Technically Feasible
%A Siripong Sirikurnpiboon
%A Paiboon Jivapaisarnpong
%J Minimally Invasive Surgery
%D 2013
%I Hindawi Publishing Corporation
%R 10.1155/2013/687134
%X Introduction. Single-access laparoscopic surgery (SALS) has been successfully introduced for colectomy surgery; however, for mid to low rectum procedures such as total mesorectal excision, it can be technically complicated. In this study, we introduced a single-access technique for rectum cancer operations without the use of other instruments. Aims. To show the short-term results of single-access laparoscopic rectal surgery in terms of pathologic results and immediate complications. Settings and Design. Prospective study. Materials and Methods. We selected middle rectum to anal canal cancer patients to undergo single-access laparoscopic rectal resection for rectal cancer. All patients had total mesorectal excisions. An umbilical incision was made for the insertion of a single multichannel port, and a mesocolic window was created to identify the inferior mesenteric artery and vein. Total mesorectal excision was performed. There were no perioperative complications. The mean operative time was 269 minutes; the median hospital stay was 7 days; the mean wound size was 5.5£¿cm; the median number of harvested lymph nodes was 15; and all patients had intact mesorectal capsules. Statistical Analysis Used. Mean, minimum¨Cmaximum. Conclusion. Single-access laparoscopic surgery for rectal cancer is feasible while oncologic principles and patient safety are maintained. 1. Introduction Single-access laparoscopic surgery (SALS) has been successfully introduced for colectomy [1]. But for mid to low rectum procedures, such as total mesorectal excision, it can be technically complicated. Only a few reports have been published about single-access laparoscopic low anterior resection [2¨C6]. The usual techniques used to maintain an adequate operative field for TME are lifting the rectum with a second forceps or suspending the rectum with transparietal sutures. In this study, however, we introduced a single-access technique for rectal surgery without the use of other instruments. 2. Materials and Methods The study took place from December, 2011 to December, 2012 in the Tertiary Care Unit of Rajavithi Hospital. All operations were performed by a colorectal surgeon. The inclusion criteria were (1) patients who had been diagnosed with cancer at the middle or low rectum or the anal canal and (2) patients who had rejected neoadjuvant chemotherapy. The exclusion criteria were (1) patients who were unfit for surgery; (2) patients who did not attend for followup; (3) patients for whom anesthesia was contraindicated; and (4) patients with asymptomatic stage IV disease. The study was
%U http://www.hindawi.com/journals/mis/2013/687134/