gms | German Medical Science

131. Kongress der Deutschen Gesellschaft für Chirurgie

Deutsche Gesellschaft für Chirurgie

25.03. - 28.03.2014, Berlin

Minimized access colorectal surgery: Experience from a single center

Meeting Abstract

  • Walter Brunner - Kantonsspital St. Gallen / Rorschach, Chirurgie Spital Rorschach, Rorschach
  • Bernhard Widmann - Kantonsspital St. Gallen / Rorschach, Chirurgie Spital Rorschach, Rorschach
  • Stephan Bischofberger - Kantonsspital St. Gallen / Rorschach, Chirurgie Spital Rorschach, Rorschach
  • Nabil Kalak - Kantonsspital St. Gallen / Rorschach, Chirurgie Spital Rorschach, Rorschach

Deutsche Gesellschaft für Chirurgie. 131. Kongress der Deutschen Gesellschaft für Chirurgie. Berlin, 25.-28.03.2014. Düsseldorf: German Medical Science GMS Publishing House; 2014. Doc14dgch094

doi: 10.3205/14dgch094, urn:nbn:de:0183-14dgch0942

Published: March 21, 2014

© 2014 Brunner et al.
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Outline

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Introduction: Innovative techniques as Single Port-and Hybrid NOTES laparoscopy have been developed to further minimize surgical access trauma. Nevertheless, experience with reduced port access in traditionally more invasive procedures, such as colon resection, is fairly limited.

Material and methods: From March 2011 to August 2013 a total of 97 colon resection were performed (39/58 m/f, age 58 y (25-91), BMI 25.1). 39% of patients had undergone previous abdominal surgery. 59 patients underwent surgery for diverticulitis, 28 for malignant intestinal neoplasia/polyps, 10 for CU, perforation or others. 23 right sided, 72 left sided resections and two total proctocolectomies were performed. Data was collected in a prospective single center-database.

Results: Mean operation time was 148 minutes. 15 of the 41 left sided procedures in women (37%) were combined with specimen retrieval via the vagina. If ileostomy was planned (6) the operation was performed via this position. In 12 of the other cases one additional trocar was used in pre-existing scars, in 4 two additional trocars were used. In three of the right sided cases conversion to open surgery was necessary. Overall postoperative complication rate was 16.4%, Clavien-Dindo IIIb or higher was 6.1% (reoperations 4 leakage, 1 ileus, 1 wound infection). Mean discharge was at day 7. All diverting ileostomies were closed inbetween.

Conclusion: Reduced port access is an innovative and still evolving way towards further reduction of interventional trauma in colorectal surgery. The technique is safe and feasible.