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Single Incision Laparoscopic Colorectal Surgery

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Single Incision Laparoscopic Colorectal Surgery - PowerPoint PPT Presentation


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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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Presentation Transcript
disclosures
Disclosures
  • Covidien Consultant
strategy to combat time constraints of laparoscopic colorectal surgery
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

slide6

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

why 3 trocars
Why 3 Trocars?
  • Simplified Technique
  • Improves Efficiency
  • Improves Learning Curve
  • Safe
why 3 trocars1
Why 3 Trocars?
  • Simplified Technique
  • Improves Efficiency
  • Improves Learning Curve
  • Safe
  • SILS!!!
preceptorship
Preceptorship
  • > 100 Surgeons
  • 1 Day preceptorship
  • All with advanced laparoscopic skills
  • All completed SILS cases
sils right colectomy
SILS Right Colectomy
  • Lose two 5mm ports
  • What else?
sils right colectomy1
SILS Right Colectomy
  • Case-Matched Trial
  • SILS vs. Lx vs. HALS
  • N = 87 (29 each group)

Papaconstantinou & Thomas

Scott & White Clinic

JACS, 2011

sils right colectomy2
SILS Right Colectomy
  • N = 87 (29)
  • Similar OR Time
  • Equivalent EBL
  • Equivalent Wound Complications

Papaconstantinou & Thomas

Scott & White Clinic

JACS, 2011

sils right colectomy3
SILS Right Colectomy
  • N = 87 (29)

Papaconstantinou & Thomas

Scott & White Clinic

JACS, 2011

sils right colectomy4
SILS Right Colectomy

CONCLUSIONS:

  • N = 87
  • Improved patient recovery
  • Decrease in early postoperative pain
  • Shorter LOS

Papaconstantinou & Thomas

Scott & White Clinic

JACS, 2011

sils colorectal1
SILS Colorectal
  • Improved recovery
      • Papaconstantinou & Thomas
  • Improved operative time
      • Marks, Geisler
  • Simplified operation
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