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Single Incision Laparoscopic Colorectal Surgery

Single Incision Laparoscopic Colorectal Surgery. Dan Geisler, MD, FACS, FASCRS. Disclosures. Covidien Consultant. M.I.C.R.S. Strategy to Combat Time Constraints of Laparoscopic Colorectal Surgery. break operation into directly productive vs. nonproductive actions

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Single Incision Laparoscopic Colorectal Surgery

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  1. Single Incision Laparoscopic Colorectal Surgery Dan Geisler, MD, FACS, FASCRS

  2. Disclosures • Covidien Consultant

  3. M.I.C.R.S.

  4. Strategy to Combat Time Constraints of Laparoscopic Colorectal Surgery • break operation into directly productive vs. nonproductive actions • standardize approach to improve efficiency • retraction performed by gravity • keep repositioning to a minimum 3 Trocar Technique

  5. RIGHT COLECTOMY 1 2 3

  6. What Can You Do Better Dan Geisler MD, John Marks MD, and Gerald Marks MD The Lankenau Hospital and Institute for Medical Research, Wynnewood, PA *San Giovanni Hospital, Rome, Italy

  7. Why 3 Trocars? • Simplified Technique • Improves Efficiency • Improves Learning Curve • Safe

  8. Why 3 Trocars? • Simplified Technique • Improves Efficiency • Improves Learning Curve • Safe • SILS!!!

  9. RIGHT COLECTOMY 1 3 2

  10. Preceptorship • > 100 Surgeons • 1 Day preceptorship • All with advanced laparoscopic skills • All completed SILS cases

  11. SILS Right Colectomy • Lose two 5mm ports • What else?

  12. SILS Right Colectomy • Case-Matched Trial • SILS vs. Lx vs. HALS • N = 87 (29 each group) Papaconstantinou & Thomas Scott & White Clinic JACS, 2011

  13. SILS Right Colectomy • N = 87 (29) • Similar OR Time • Equivalent EBL • Equivalent Wound Complications Papaconstantinou & Thomas Scott & White Clinic JACS, 2011

  14. SILS Right Colectomy • N = 87 (29) Papaconstantinou & Thomas Scott & White Clinic JACS, 2011

  15. SILS Right Colectomy CONCLUSIONS: • N = 87 • Improved patient recovery • Decrease in early postoperative pain • Shorter LOS Papaconstantinou & Thomas Scott & White Clinic JACS, 2011

  16. SILS Colorectal

  17. SILS Colorectal • Improved recovery • Papaconstantinou & Thomas • Improved operative time • Marks, Geisler • Simplified operation

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