Single-incision laparoscopic-assisted surgery for colon cancer via a periumbilical approach using a surgical glove: Initial experience with 9 cases

Our initial experience of performing a single-incision laparoscopic-assisted (SILS) colectomy using a “home-made” multichannel port system is presented. Nine patients (5 women) with a median age of 67 years (range, 55–72 years) and a median body mass index of 21.2 kg/m2 (range, 17.8–26.7 kg/m2) underwent the SILS colectomy for colon cancer between September 2009 and March 2010. The sites of the primary tumor were the ascending colon (n = 2), hepatic flexure (n = 1), transverse colon (n = 2), and sigmoid colon (n = 4). Each trocar was introduced intraperitoneally through each finger of a surgical glove attached to the wound protector, which was applied to a midline fasciotomy made via a ¾-circular periumbilical incision. If necessary, one to three radial splits were added to the incision. The colon was mobilized intracorporeally, and the vessels were ligated intra- or extracorporeally. All the patients underwent a curative segmental colectomy without conversion to a standard multiport laparoscopy or open surgery. The median operative time and blood loss were 140 min (range, 135–165 min) and 50 mL (range, 20–225 mL), respectively. The median number of harvested lymph nodes was 18 (range, 6–31). The pathological stages included stage 0 (n = 2), stage I (n = 6), and stage III (n = 1). The median number of postoperative analgesic use was one (range, 0–6). No intra- or postoperative complications occurred in this series. Our SILS colectomy procedure seems feasible and safe in selected patients with colon cancer.