Single-incision versus multiport laparoscopic right and hand-assisted left colectomy: a case-matched comparison

Area of Science:

• Minimally Invasive Surgery
• Surgical Oncology
• Gastrointestinal Surgery

Background:

• Single-incision laparoscopic colectomy (SILC) technology is available, but its benefits over traditional multiport laparoscopic colectomy (MLC) remain unproven.
• Limited evidence exists comparing the clinical and cosmetic outcomes of SILC and MLC.

Purpose of the Study:

• To compare perioperative outcomes, cosmesis, and body image scores between patients undergoing SILC and MLC.
• To evaluate the safety and efficacy of SILC in a real-world setting.

Main Methods:

• A case-matched study comparing consecutive SILC patients with MLC patients.
• Matching criteria included age, operation type, surgeon, diagnosis, and body mass index.
• Data were collected from a prospective database and patient medical records at two tertiary care hospitals.

Main Results:

• SILC resulted in a significantly shorter largest incision length and higher cosmetic scores (P = .03).
• Time to flatus and bowel movements were shorter in the SILC group, with similar lengths of stay.
• Operative times were similar for right colectomies but longer for left colectomies in the SILC group; attending surgeons performed a greater portion of SILC procedures.

Conclusions:

• Single-incision laparoscopic colectomy is equivalent to multiport laparoscopic colectomy in terms of safety and efficacy.
• SILC offers advantages in smaller incision size and improved cosmetic outcomes.
• Further prospective research is needed to fully elucidate the benefits of SILC.