SILS v SILS+1: a Case-Matched Comparison for Colorectal Surgery

Area of Science:

• Minimally Invasive Surgery
• Surgical Oncology
• Colorectal Surgery

Background:

• Single-incision laparoscopic surgery (SILS) is a feasible approach for colorectal diseases.
• SILS presents technical challenges in pelvic operations.
• The SILS+1 technique was developed to overcome these limitations.

Purpose of the Study:

• To compare the outcomes of SILS and SILS+1 in lower abdominal and pelvic colorectal surgery.
• To evaluate the efficacy of an additional port in SILS procedures.
• To assess the impact of SILS+1 on operative time, conversion rates, and postoperative outcomes.

Main Methods:

• A retrospective review of patients undergoing elective reduced port laparoscopic colorectal surgery (2009-2014).
• Patients were stratified into SILS and SILS+1 groups and matched 1:2 based on demographic and clinical factors.
• Key outcome measures included operative time, conversion rates, length of stay, and complication rates.

Main Results:

• The SILS+1 group demonstrated significantly shorter operative times (166.6 vs. 178.0 minutes) and lower conversion rates (1.1% vs. 11.4%) compared to SILS.
• Groups were similar in age, gender, BMI, and ASA class.
• No significant differences were observed in length of stay, complication, morbidity, or mortality rates.

Conclusions:

• The SILS+1 approach enhances pelvic and lower abdominal colorectal surgery.
• This technique leads to improved operative efficiency and reduced need for conversion to multiport or open surgery.
• SILS+1 achieves these benefits without negatively impacting postoperative recovery or complication profiles.