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Single-incision Laparoscopy Versus Multiport Laparoscopy for Colonic Surgery: A Multicenter, Double-blinded,
Léon Maggiori1, Jean Jacques Tuech2, Eddy Cotte3
1Colorectal Surgery Department, Hôpital Beaujon, Assistance Publique-Hôpitaux de Paris, University Paris VII, Clichy, France.
Annals of Surgery
|October 11, 2018
Summary
Single-port laparoscopy (SPL) colectomy offers no significant clinical advantages over multiport laparoscopy (MPL) for colonic surgery. Patients in the SPL group reported higher satisfaction with scar appearance, but other outcomes were similar.
Area of Science:
- Minimally Invasive Surgery
- Colorectal Surgery
- Surgical Outcomes
Background:
- Single-port laparoscopy (SPL) is an advanced minimally invasive technique.
- Evidence comparing SPL to multiport laparoscopy (MPL) in colonic surgery is limited.
- Large randomized trials are needed to establish SPL benefits.
Purpose of the Study:
- To compare the outcomes of single-port laparoscopy (SPL) versus multiport laparoscopy (MPL) for colonic surgery.
- To evaluate if SPL offers advantages over MPL in terms of clinical outcomes.
- To assess patient satisfaction and cosmetic results following SPL and MPL.
Main Methods:
- Prospective, double-blinded, superiority trial.
- 125 patients undergoing laparoscopic colonic resection (benign or malignant) were randomized to SPL or MPL.
- Primary outcome was length of theoretical hospital stay (LHS).
Main Results:
- Total skin incision length was significantly shorter in the SPL group (P < 0.001).
- Procedure duration, complications, pain, and time to first bowel movement were similar between SPL and MPL.
- Length of theoretical hospital stay was comparable (SPL: 6±3 days vs. MPL: 6±2 days).
- Patients in the SPL group reported significantly higher satisfaction with scar appearance (P = 0.003).
Conclusions:
- Single-port laparoscopy colectomy does not provide additional clinical benefits compared to multiport laparoscopy.
- The primary advantage of SPL in colonic surgery appears to be cosmetic.
- MPL remains a viable and effective surgical approach for colonic resections.
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