Single-Access Laparoscopic Colectomy Utilizing Gravity in the Lateral Decubitus Position
BACKGROUND:Only a limited number of instruments can be used in single-access laparoscopic colectomy, and triangulation must be forfeited to avoid instrument collision. We investigated whether this problem could be overcome by performing laparoscopic colectomy by the use of the lateral decubitus posi...
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| Veröffentlicht in: | Diseases of the colon & rectum 2012-12, Vol.55 (12), p.1295-1299 |
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| creator | Uematsu, Dai Akiyama, Gaku Magishi, Akiko Komatsu, Hirokazu Sano, Takayuki |
| description | BACKGROUND:Only a limited number of instruments can be used in single-access laparoscopic colectomy, and triangulation must be forfeited to avoid instrument collision. We investigated whether this problem could be overcome by performing laparoscopic colectomy by the use of the lateral decubitus position, making full use of gravity.
OBJECTIVE:The aim of this study was to determine whether single-access laparoscopic colectomy could be achieved while maintaining patients in the lateral decubitus position.
DESIGN:This was a prospective study.
SETTING:This single-center study was conducted in a hospital.
PATIENTS:Ten consecutive patients (4 men and 6 women) with stage II or III colon cancer were included.
INTERVENTIONS:Each patient was placed in the lateral decubitus position. Single-port access to the abdomen was provided by a 3.0-cm incision at the umbilicus. The roots of the supplying or draining vessels were isolated and divided for lymphadenectomy. Next, the colon was dissected from a lateral approach, without the help of the assistant. The specimen was extracted from the single-access incision. Extracorporeal or intracorporeal anastomosis was performed.
MAIN OUTCOME MEASURES:The primary outcome measured was the feasibility of single-access laparoscopic colectomy in the lateral decubitus position.
RESULTS:There were no intraoperative complications and no need for conversions to conventional laparoscopic surgery, open surgery, or the supine position. The median total surgical time was 154 minutes (interquartile range, 135–220 minutes). Surgical blood loss was slight ( |
| doi_str_mv | 10.1097/DCR.0b013e31826eef63 |
| format | Article |
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OBJECTIVE:The aim of this study was to determine whether single-access laparoscopic colectomy could be achieved while maintaining patients in the lateral decubitus position.
DESIGN:This was a prospective study.
SETTING:This single-center study was conducted in a hospital.
PATIENTS:Ten consecutive patients (4 men and 6 women) with stage II or III colon cancer were included.
INTERVENTIONS:Each patient was placed in the lateral decubitus position. Single-port access to the abdomen was provided by a 3.0-cm incision at the umbilicus. The roots of the supplying or draining vessels were isolated and divided for lymphadenectomy. Next, the colon was dissected from a lateral approach, without the help of the assistant. The specimen was extracted from the single-access incision. Extracorporeal or intracorporeal anastomosis was performed.
MAIN OUTCOME MEASURES:The primary outcome measured was the feasibility of single-access laparoscopic colectomy in the lateral decubitus position.
RESULTS:There were no intraoperative complications and no need for conversions to conventional laparoscopic surgery, open surgery, or the supine position. The median total surgical time was 154 minutes (interquartile range, 135–220 minutes). Surgical blood loss was slight (<20 mL) in all patients. No postoperative complications occurred. The median postoperative hospital stay was 7 days (interquartile range, 5–7 days).
LIMITATIONS:The sample size was small.
CONCLUSIONS:Our results show that single-access laparoscopic colectomy in the lateral decubitus position is safe and feasible.</description><identifier>ISSN: 0012-3706</identifier><identifier>EISSN: 1530-0358</identifier><identifier>DOI: 10.1097/DCR.0b013e31826eef63</identifier><identifier>PMID: 23135589</identifier><identifier>CODEN: DICRAG</identifier><language>eng</language><publisher>Hagerstown, MDc: The ASCRS</publisher><subject>Aged ; Aged, 80 and over ; Biological and medical sciences ; Colectomy - methods ; Colonic Neoplasms - surgery ; Digestive system. Abdomen ; Endoscopy ; Female ; Gastroenterology. Liver. Pancreas. Abdomen ; Humans ; Investigative techniques, diagnostic techniques (general aspects) ; Laparoscopy - methods ; Length of Stay - statistics & numerical data ; Male ; Medical sciences ; Middle Aged ; Patient Positioning ; Prospective Studies ; Stomach, duodenum, intestine, rectum, anus ; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases ; Surgery of the digestive system ; Treatment Outcome</subject><ispartof>Diseases of the colon & rectum, 2012-12, Vol.55 (12), p.1295-1299</ispartof><rights>The ASCRS 2012</rights><rights>2014 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c4015-ac76efda96e4e2a73e758e1fc19aac7ef56b1d891744ca191b9a15a9d04cea0b3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27901,27902</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=26669473$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/23135589$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Uematsu, Dai</creatorcontrib><creatorcontrib>Akiyama, Gaku</creatorcontrib><creatorcontrib>Magishi, Akiko</creatorcontrib><creatorcontrib>Komatsu, Hirokazu</creatorcontrib><creatorcontrib>Sano, Takayuki</creatorcontrib><title>Single-Access Laparoscopic Colectomy Utilizing Gravity in the Lateral Decubitus Position</title><title>Diseases of the colon & rectum</title><addtitle>Dis Colon Rectum</addtitle><description>BACKGROUND:Only a limited number of instruments can be used in single-access laparoscopic colectomy, and triangulation must be forfeited to avoid instrument collision. We investigated whether this problem could be overcome by performing laparoscopic colectomy by the use of the lateral decubitus position, making full use of gravity.
OBJECTIVE:The aim of this study was to determine whether single-access laparoscopic colectomy could be achieved while maintaining patients in the lateral decubitus position.
DESIGN:This was a prospective study.
SETTING:This single-center study was conducted in a hospital.
PATIENTS:Ten consecutive patients (4 men and 6 women) with stage II or III colon cancer were included.
INTERVENTIONS:Each patient was placed in the lateral decubitus position. Single-port access to the abdomen was provided by a 3.0-cm incision at the umbilicus. The roots of the supplying or draining vessels were isolated and divided for lymphadenectomy. Next, the colon was dissected from a lateral approach, without the help of the assistant. The specimen was extracted from the single-access incision. Extracorporeal or intracorporeal anastomosis was performed.
MAIN OUTCOME MEASURES:The primary outcome measured was the feasibility of single-access laparoscopic colectomy in the lateral decubitus position.
RESULTS:There were no intraoperative complications and no need for conversions to conventional laparoscopic surgery, open surgery, or the supine position. The median total surgical time was 154 minutes (interquartile range, 135–220 minutes). Surgical blood loss was slight (<20 mL) in all patients. No postoperative complications occurred. The median postoperative hospital stay was 7 days (interquartile range, 5–7 days).
LIMITATIONS:The sample size was small.
CONCLUSIONS:Our results show that single-access laparoscopic colectomy in the lateral decubitus position is safe and feasible.</description><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Biological and medical sciences</subject><subject>Colectomy - methods</subject><subject>Colonic Neoplasms - surgery</subject><subject>Digestive system. Abdomen</subject><subject>Endoscopy</subject><subject>Female</subject><subject>Gastroenterology. Liver. Pancreas. Abdomen</subject><subject>Humans</subject><subject>Investigative techniques, diagnostic techniques (general aspects)</subject><subject>Laparoscopy - methods</subject><subject>Length of Stay - statistics & numerical data</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Patient Positioning</subject><subject>Prospective Studies</subject><subject>Stomach, duodenum, intestine, rectum, anus</subject><subject>Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases</subject><subject>Surgery of the digestive system</subject><subject>Treatment Outcome</subject><issn>0012-3706</issn><issn>1530-0358</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2012</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpdkVFrFDEQgINY7Fn9ByL7IviyNbPZZDeP5Vpb4cBSLfgWZnOzXjS3OZOs5fz1TelpwYEwDPkmQ75h7A3wU-C6-3C-vDnlAwdBAvpGEY1KPGMLkILXXMj-OVtwDk0tOq6O2cuUfpSSN7x7wY4bAULKXi_Yty9u-u6pPrOWUqpWuMMYkg07Z6tl8GRz2O6r2-y8-1PI6jLib5f3lZuqvKHCZ4roq3Oy8-DynKrrkFx2YXrFjkb0iV4f8gm7_XjxdXlVrz5fflqerWrbcpA12k7RuEatqKUGO0Gd7AlGCxrLHY1SDbDuNXRtaxE0DBpBol7z1hLyQZyw94_v7mL4NVPKZuuSJe9xojAnAyCBC9EIXtD2EbXliynSaHbRbTHuDXDz4NQUp-Z_p6Xt7WHCPGxp_a_pr8QCvDsAmCz6MeJkXXrilFK67cTT_Lvgi7b00893FM2G0OeN4SVEK0XdlK1BU6q6nLLOe7OmkR4</recordid><startdate>201212</startdate><enddate>201212</enddate><creator>Uematsu, Dai</creator><creator>Akiyama, Gaku</creator><creator>Magishi, Akiko</creator><creator>Komatsu, Hirokazu</creator><creator>Sano, Takayuki</creator><general>The ASCRS</general><general>Lippincott Williams & Wilkins</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>201212</creationdate><title>Single-Access Laparoscopic Colectomy Utilizing Gravity in the Lateral Decubitus Position</title><author>Uematsu, Dai ; Akiyama, Gaku ; Magishi, Akiko ; Komatsu, Hirokazu ; Sano, Takayuki</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4015-ac76efda96e4e2a73e758e1fc19aac7ef56b1d891744ca191b9a15a9d04cea0b3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2012</creationdate><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Biological and medical sciences</topic><topic>Colectomy - methods</topic><topic>Colonic Neoplasms - surgery</topic><topic>Digestive system. Abdomen</topic><topic>Endoscopy</topic><topic>Female</topic><topic>Gastroenterology. Liver. Pancreas. Abdomen</topic><topic>Humans</topic><topic>Investigative techniques, diagnostic techniques (general aspects)</topic><topic>Laparoscopy - methods</topic><topic>Length of Stay - statistics & numerical data</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Patient Positioning</topic><topic>Prospective Studies</topic><topic>Stomach, duodenum, intestine, rectum, anus</topic><topic>Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases</topic><topic>Surgery of the digestive system</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Uematsu, Dai</creatorcontrib><creatorcontrib>Akiyama, Gaku</creatorcontrib><creatorcontrib>Magishi, Akiko</creatorcontrib><creatorcontrib>Komatsu, Hirokazu</creatorcontrib><creatorcontrib>Sano, Takayuki</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Diseases of the colon & rectum</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Uematsu, Dai</au><au>Akiyama, Gaku</au><au>Magishi, Akiko</au><au>Komatsu, Hirokazu</au><au>Sano, Takayuki</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Single-Access Laparoscopic Colectomy Utilizing Gravity in the Lateral Decubitus Position</atitle><jtitle>Diseases of the colon & rectum</jtitle><addtitle>Dis Colon Rectum</addtitle><date>2012-12</date><risdate>2012</risdate><volume>55</volume><issue>12</issue><spage>1295</spage><epage>1299</epage><pages>1295-1299</pages><issn>0012-3706</issn><eissn>1530-0358</eissn><coden>DICRAG</coden><abstract>BACKGROUND:Only a limited number of instruments can be used in single-access laparoscopic colectomy, and triangulation must be forfeited to avoid instrument collision. We investigated whether this problem could be overcome by performing laparoscopic colectomy by the use of the lateral decubitus position, making full use of gravity.
OBJECTIVE:The aim of this study was to determine whether single-access laparoscopic colectomy could be achieved while maintaining patients in the lateral decubitus position.
DESIGN:This was a prospective study.
SETTING:This single-center study was conducted in a hospital.
PATIENTS:Ten consecutive patients (4 men and 6 women) with stage II or III colon cancer were included.
INTERVENTIONS:Each patient was placed in the lateral decubitus position. Single-port access to the abdomen was provided by a 3.0-cm incision at the umbilicus. The roots of the supplying or draining vessels were isolated and divided for lymphadenectomy. Next, the colon was dissected from a lateral approach, without the help of the assistant. The specimen was extracted from the single-access incision. Extracorporeal or intracorporeal anastomosis was performed.
MAIN OUTCOME MEASURES:The primary outcome measured was the feasibility of single-access laparoscopic colectomy in the lateral decubitus position.
RESULTS:There were no intraoperative complications and no need for conversions to conventional laparoscopic surgery, open surgery, or the supine position. The median total surgical time was 154 minutes (interquartile range, 135–220 minutes). Surgical blood loss was slight (<20 mL) in all patients. No postoperative complications occurred. The median postoperative hospital stay was 7 days (interquartile range, 5–7 days).
LIMITATIONS:The sample size was small.
CONCLUSIONS:Our results show that single-access laparoscopic colectomy in the lateral decubitus position is safe and feasible.</abstract><cop>Hagerstown, MDc</cop><pub>The ASCRS</pub><pmid>23135589</pmid><doi>10.1097/DCR.0b013e31826eef63</doi><tpages>5</tpages></addata></record> |
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| ispartof | Diseases of the colon & rectum, 2012-12, Vol.55 (12), p.1295-1299 |
| issn | 0012-3706 1530-0358 |
| language | eng |
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| source | MEDLINE; Journals@Ovid Complete |
| subjects | Aged Aged, 80 and over Biological and medical sciences Colectomy - methods Colonic Neoplasms - surgery Digestive system. Abdomen Endoscopy Female Gastroenterology. Liver. Pancreas. Abdomen Humans Investigative techniques, diagnostic techniques (general aspects) Laparoscopy - methods Length of Stay - statistics & numerical data Male Medical sciences Middle Aged Patient Positioning Prospective Studies Stomach, duodenum, intestine, rectum, anus Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases Surgery of the digestive system Treatment Outcome |
| title | Single-Access Laparoscopic Colectomy Utilizing Gravity in the Lateral Decubitus Position |
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