Noncosmetic benefits of single-incision laparoscopic sigmoid colectomy for diverticular disease: A case-matched comparison with multiport laparoscopic technique

• Published in: The Journal of surgical research Vol. 180; no. 2; pp. 201 - 207
• Main Authors: Vasilakis, Vasileios, MD, Clark, Clarence E., MD, Liasis, Lampros, MD, Papaconstantinou, Harry T., MD
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01-04-2013
• Subjects: Adult; Aged; Aged, 80 and over; Case-matched; Colectomy; Colectomy - methods; Colon, Sigmoid - surgery; Cosmetic; Diverticular disease; Diverticulum - surgery; Female; Humans; Laparoscopic; Laparoscopy - methods; Length of Stay; Male; Middle Aged; Outcomes; Pain; Pain Measurement; Pain, Postoperative - physiopathology; Postoperative Care; Sigmoid; Single-incision; Surgery; Diverticular disease; Case-matched; Cosmetic; Single-incision; Pain; Colectomy; Laparoscopic; Sigmoid; Outcomes; Length of stay
• ISSN: 0022-4804; 1095-8673
• DOI: 10.1016/j.jss.2012.04.063

Abstract Background Single-incision laparoscopic (SIL) colectomy has gained significant momentum with anticipated benefit of improved cosmesis. Feasibility and safety of SIL colectomy have been shown; however, benefits are not well defined. The purpose of this study is to directly compare outcomes of SIL sigmoid colectomy for diverticular disease with standard multiport laparoscopic (LAP) technique. Methods SIL sigmoid colectomy cases performed for diverticular disease between August 2009 and July 2011 were case matched for age, gender, body mass index, American Society of Anesthesiologists score, previous abdominal operation, and need to mobilize the splenic flexure and compared with an equal number of LAP cases. Data analyzed included operative time, estimated blood loss, procedure conversion, incision length, length of hospital stay (LOS), 30-d hospital readmission, and postoperative pain scores. Results Twenty patients were analyzed in each group with no significant differences found in the six case-matching criteria. Operative time, conversions, estimated blood loss, surgical site infection, and hospital readmissions were similar. The mean incision length for both groups was 5 cm ( P = 0.72). LOS was 3.7 d for the SIL group, which was >1 d shorter than that for the LAP group (5.0 d; P < 0.05). Pain score at post-anesthesia care unit discharge and total amount of narcotic pain medication delivered in the post-anesthesia care unit was significantly less in the SIL group ( P < 0.05), as was maximum visual analog scale pain score on postoperative day 1 and postoperative day 2 ( P ≤ 0.01). Conclusions SIL sigmoid colectomy is associated with noncosmetic benefits, including a reduction in early postoperative pain and decreased LOS. These findings may be related to reduced abdominal wall trauma.