Dec 2 2009
Building upon the momentum and success of its rapidly growing single-incision laparoscopic surgery program, Saint Louis University Hospital recently performed one of the first total abdominal colectomies, including reconstruction of the intestinal tract by reconnection of the remaining small intestine to the rectum, via single-incision laparoscopy. This procedure is a critical advancement in minimally-invasive surgery.
Ovunc Bardakcioglu, M.D., a gastrointestinal surgeon at SLU Hospital and director of the hospital’s single-incision laparoscopic program, performed the procedure on a 64-year-old male with colon cancer, extracting approximately 40 inches of colon through a four-centimeter incision below the bellybutton region. The patient was discharged home just four days after surgery and has not experienced any immediate postoperative complications.
“A laparoscopic total colectomy is already one of the most advanced and difficult laparoscopic procedures working with a large organ in all quadrants of the abdomen,” says Dr. Bardakcioglu. “Performing this procedure using a single incision is an even greater challenge. However, it’s advancing gastrointestinal surgery as we know it, providing benefits for our patients.”
Currently, single-incision laparoscopy is performed for basic laparoscopic procedures involving single abdominal quadrants, such as appendectomies, gall bladder removals and, more recently, partial colectomies. This total colectomy case indicates that single-incision laparoscopic techniques can be utilized for more complex abdominal laparoscopic procedures with a large organ and a working space involving all quadrants of the abdominal cavity. Some of these techniques may be applied and further adapted for colonic resection via a natural orifice in the future. More importantly, this procedure is a major step towards natural orifice colectomies.
Single-incision surgery involves the use of a flexible scope and instruments that can easily move around inside the body and produce images from almost every angle. The instrument also provides surgeons with a larger field of view and helps them avoid situations where the tips of different instruments collide in smaller spaces during the operation.
The single-incision surgery team at SLU Hospital has already performed a number of gastrointestinal procedures, including appendectomies, gall bladder removals and partial colectomies.
“I believe that single-incision laparoscopic surgery has the potential to become the preferred method of the future,” predicts Dr. Bardakcioglu. “It certainly has the most promise for patients – they enjoy the aesthetic benefit of fewer visible post-operative scars, and based on some preliminary studies, may experience less pain and a quicker recovery.”