J Minim Invasive Surg.  2018 Mar;21(1):38-42. 10.7602/jmis.2018.21.1.38.

Repeat Single Incision Laparoscopic Surgery after Primary Single Incision Laparoscopic Surgery for Colorectal Disease

• Kim SH
• Yun SH
• Park YA
• Cho YB
• Kim HC
• Lee WY

• KMID: 2436239
• DOI: http://doi.org/10.7602/jmis.2018.21.1.38

Abstract

PURPOSE
Single-incision laparoscopic surgery (SILS) for colorectal surgery is widely performed for many disease entities. However, there are few reports about the role of repeat single-incision laparoscopic surgery (R-SILS). The aim of this study is to analyze R-SILS data to evaluate the feasibility and safety of the occurrence and review its outcomes.
METHODS
This is a retrospective review of the prospectively collected SILS database in Samsung Medical Center, Seoul, Korea, between April 2009 and December 2015. A retrospective review of 38 patients who underwent R-SILS from 2,207 patients who underwent primary SILS for colorectal surgery was performed.
RESULTS
The indications of R-SILS were 23 primary SILS-related complications, 10 cancer-related, and 5 other surgical indications. Of the 38 repeat surgeries, 24 were emergent operations, and 14 were elective operations. Fecal diversion for anastomotic leakage after rectal surgery was the most common reason for reoperation. There were 2 cases of conversions: one case was converted to conventional multi-port, and the other case was converted to open surgery. Mean operative time was 137.9±64.1 min, estimated blood loss (EBL) was 105±98 ml, and length of hospital stay was 10.1±8.1 days. Post-operative complication was noted in 5 (13.2%) of 38 R-SILS cases, and there was no 30-day postoperative mortality.
CONCLUSION
Repeat single-incision laparoscopy surgery is feasible and safe in select patients when performed by an experienced surgeon.

Keyword

Minimally invasive surgical procedures; Single-incision laparoscopic surgery; Repeat operation; Colorectal surgery

MeSH Terms

Anastomotic Leak
Colorectal Surgery
Humans
Korea
Laparoscopy*
Length of Stay
Minimally Invasive Surgical Procedures
Mortality
Operative Time
Prospective Studies
Reoperation
Retrospective Studies
Seoul