INTRODUCTION: Single incision laparoscopic surgery (SILS) may be even less invasive to patients than conventional laparoscopic surgery (CLS). The present study investigates the applicability of the procedure and we report the first year of experiences and operative quality. MATERIAL AND METHODS: Patients were selected clinically and after computed tomography. Easy resections (or stoma creations) with small tumours, a body mass index < 30 kg/square meter and American Society of Anesthesiologists group I-II were included. The data were prospectively registered until 1 January 2012. In the standard accelerated "fast track" programme, the use of additional opioids was registered. RESULTS: SILS was performed in 24 patients including 15 patients with cancer resections. In eight stoma creations, no scars were left other than the stoma hole. The overall conversion rate was 17% and the complication rate was 13% with no wound infections. In the 15 SILS colon resections, median operation time (171 min.), blood loss (0 ml), lymph node harvest (median n = 14), dissection quality (73% mesocolic), specimen length (23 cm), height of vascular pedicle (8 cm) and hospital stay (three days) were comparable to international reports. One serious complication of small bowel injury was seen, but this was the only complication (7%) in this group. CONCLUSION: With the proviso that our study population was limited in size, SILS seems equal to CLS in colorectal cancer surgery - although with a high conversion rate in the learning period, and it is a suitable procedure for minimal invasion in creation of a stoma.
INTRODUCTION: Single incision laparoscopic surgery (SILS) may be even less invasive to patients than conventional laparoscopic surgery (CLS). The present study investigates the applicability of the procedure and we report the first year of experiences and operative quality. MATERIAL AND METHODS:Patients were selected clinically and after computed tomography. Easy resections (or stoma creations) with small tumours, a body mass index < 30 kg/square meter and American Society of Anesthesiologists group I-II were included. The data were prospectively registered until 1 January 2012. In the standard accelerated "fast track" programme, the use of additional opioids was registered. RESULTS: SILS was performed in 24 patients including 15 patients with cancer resections. In eight stoma creations, no scars were left other than the stoma hole. The overall conversion rate was 17% and the complication rate was 13% with no wound infections. In the 15 SILS colon resections, median operation time (171 min.), blood loss (0 ml), lymph node harvest (median n = 14), dissection quality (73% mesocolic), specimen length (23 cm), height of vascular pedicle (8 cm) and hospital stay (three days) were comparable to international reports. One serious complication of small bowel injury was seen, but this was the only complication (7%) in this group. CONCLUSION: With the proviso that our study population was limited in size, SILS seems equal to CLS in colorectal cancer surgery - although with a high conversion rate in the learning period, and it is a suitable procedure for minimal invasion in creation of a stoma.