Single-incision laparoscopic total colectomy using an organ retractor: A case report

Area of Science:

• Minimally invasive surgery
• Surgical instrumentation
• Colorectal surgery

Background:

• Single-incision laparoscopic surgery (SILS) offers cosmetic and recovery benefits but faces technical challenges due to restricted instrument movement.
• Organ retractors are designed to mitigate these limitations by improving surgical field visualization.
• Managing severe gastrointestinal bleeding often requires advanced surgical techniques.

Observation:

• A case study involving an 85-year-old female patient presenting with hematochezia due to uncontrollable diverticular bleeding from the ascending colon.
• Despite endoscopic intervention, bleeding persisted, necessitating surgical management.
• Single-incision laparoscopic surgery (SILS) total colectomy was performed using an organ retractor to address the severe diverticular bleeding.

Findings:

• The organ retractor facilitated adequate operative visualization during SILS total colectomy, enabling precise dissection of the hepatocolic ligament, ileocolic vessels, and sigmoid colon mesentery.
• Tension adjustment of the organ retractor was crucial for maintaining a clear surgical view throughout the procedure.
• The patient experienced an uneventful postoperative recovery.

Implications:

• Organ retractors are effective tools for overcoming the technical difficulties associated with SILS, particularly in complex colorectal procedures.
• This approach can enable safe and efficient dissection in SILS, potentially expanding its application.
• The successful use of an organ retractor in this case highlights its value in managing severe diverticular bleeding via minimally invasive colectomy.