Abstract
Background. Single Port Laparoscopic Surgery (SPLS) is being increasingly employed in colorectal surgery for benign and malignant diseases. The particular role for SPLS in inflammatory bowel disease (IBD) has not been determined yet. In this review article we summarize technical aspects and short term results of SPLS resections in patients with Crohn's disease or ulcerative colitis. Methods. A systematic review of the literature until January 2012 was performed. Publications were assessed for operative techniques, equipment, surgical results, hospital stay, and readmissions. Results. 34 articles, published between 2010 and 2012, were identified reporting on 301 patients with IBD that underwent surgical treatment in SPLS technique. Surgical procedures included ileocolic resections, sigmoid resections, colectomies with end ileostomy or ileorectal anastomosis, and restorative proctocolectomies with ileum-pouch reconstruction. There was a wide variety in the surgical technique and the employed equipment. The overall complication profile was similar to reports on standard laparoscopic surgery in IBD. Conclusions. In experienced hands, single port laparoscopic surgery appears to be feasible and safe for the surgical treatment of selected patients with IBD. However, evidence from prospective randomized trials is required in order to clarify whether there is a further benefit apart from the avoidance of additional trocar incisions.
Highlights
Single-Port Laparoscopic Surgery (SPLS) is a development in the field of minimally invasive surgery that aims to minimize the surgical access trauma by reducing the number of abdominal incisions to a single incision
The number of publications on the subject is growing at a fast pace: whereas first case reports arose in 2010, larger case series from specialized centers are available that demonstrate the feasibility of Single Port Laparoscopic Surgery (SPLS) in inflammatory bowel disease (IBD)
Most of the currently available studies on the application of SPLS in colorectal surgery which include IBD patients are not restricted to single procedures in single pathological conditions, but rather describe mixed cohorts
Summary
Single-Port Laparoscopic Surgery (SPLS) is a development in the field of minimally invasive surgery that aims to minimize the surgical access trauma by reducing the number of abdominal incisions to a single incision. Various procedures in colonic surgery have been performed in SPLS technique: Both right and left hemicolectomies, sigmoid resections, and proctocolectomies with formation of an ileum-J-pouch have been reported (review in [5,6,7]). In these studies, indications for SPLS colonic operations included chronic diverticulitis, Crohn’s disease, ulcerative colitis, familial adenomatous polyposis, large adenoma, and carcinoma of the colon. The aim of this systematic review was to analyze the currently available literature on single-port laparoscopic surgery in patients with IBD with respect to feasibility, reported techniques, and safety and to identify potential benefits of this new technique in this particular group of patients. Evidence from prospective randomized trials is required in order to clarify whether there is a further benefit apart from the avoidance of additional trocar incisions
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