Single-incision laparoscopic-assisted surgery for colon cancer via a periumbilical approach using a surgical glove:...

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/m(2) (range, 17.8-26.7 kg/m(2)) 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.