In recent years, single-incision laparoscopic surgery (SILS) has further reduced the invasive nature of surgical procedures and provided even greater cosmetic benefits than conventional laparoscopic surgery (CLS) [1]. In SILS, a single incision is typically made at the umbilicus, and specially developed access devices are used for the introduction of trocars and instruments [2]. In most cases, no other abdominal wounds are required, and the umbilical incision, although larger than that of conven- tional laparoscopy, is minimally visible once healed. Recent reports have provided accumulating evidence of the feasibility and safety of SILS for gastrointestinal and colorectal procedures, including colectomy, sigmoi- dectomy, gastrojejunostomy and bariatric surgery [3–8]. Despite these encouraging reports, challenges remain with SILS. Most commercially available access devices are rigid, and because only one access point is used, instrument crowding can hamper dissection [2]. In addition, because the instruments are parallel to each other, the range of motion is limited, further increasing the difficulty of tissue manipulation and dissection. To overcome these obstacles, relatively costly specially curved instruments are typically used, while some authors have produced novel solutions.
In an effort to simplify SILS, we have modified the design of a previously described home-made single- incision access device [9] using a commercially available wound protector and surgical glove to make it more suitable for single-incision laparoscopic colorectal surgery.
In conclusion, the results of this report provide further evidence of the feasibility of SILS for the treatment of colorectal disease. Our results indicate that SILS is as effective as CLS, and is not associated with increased duration of surgery, blood loss, or complications. simple, home-made access device addresses the issue of instrument crowding. |
