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Gao P, Cai H, Peng B, Cai Y. Single-port laparoscopic pancreaticoduodenectomy. Surg Endosc 2023; 37:1166-1172. [PMID: 36151394 DOI: 10.1007/s00464-022-09618-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Accepted: 09/07/2022] [Indexed: 11/25/2022]
Abstract
BACKGROUND Performing a single-port laparoscopic pancreatectomy is technically challenging. Single-port laparoscopic pancreaticoduodenectomy (SPLPD) is rarely reported in English literature. METHODS Eighty-seven cases of laparoscopic pancreaticoduodenectomy (LPD) were performed by a single surgical team in the Department of Pancreatic Surgery, West China Hospital, Sichuan University between February 2020 and December 2020. Among these, 13 cases of LPD (group 1) were performed using a single-port device. Basing on the same inclusion and exclusion criteria, 68 cases of LPD performed using traditional 5-trocar were included as a control group (group 2). The patient's demographic characteristics, intraoperative, and postoperative variables were prospectively collected and retrospectively analyzed. RESULTS Five men and eight women were included in the SPLPD group. The median age of these patients was 57 years. The patients who underwent SPLPD required a longer operative time (332.7 ± 38.1 min vs. 305.8 ± 64.7 min; p = 0.03) than those in the LPD group. The estimated blood loss, conversion rate, blood transfusion rate, time to oral intake, postoperative hospital stays, and perioperative complications were comparable between the two groups. The short-term oncological outcomes, such as R0 rate and lymph node harvested, were comparable between the two groups. The 90-day mortality of all patients was zero. CONCLUSIONS SPLPD is a safe and feasible procedure for well-selected patients in an experienced minimally invasive pancreatic surgery team. SPLPD may provide several potential advantages, such as the requirement of fewer trocars, fewer abdominal complications, and reduced participation of assistants than conventional LPD.
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Affiliation(s)
- Pan Gao
- Department of Pancreatic Surgery, West China Hospital, Sichuan University, Chengdu, No 37, Guo Xue Xiang, Chengdu, 610041, Sichuan, China
| | - He Cai
- Department of Pancreatic Surgery, West China Hospital, Sichuan University, Chengdu, No 37, Guo Xue Xiang, Chengdu, 610041, Sichuan, China
| | - Bing Peng
- Department of Pancreatic Surgery, West China Hospital, Sichuan University, Chengdu, No 37, Guo Xue Xiang, Chengdu, 610041, Sichuan, China
| | - Yunqiang Cai
- Department of Pancreatic Surgery, West China Hospital, Sichuan University, Chengdu, No 37, Guo Xue Xiang, Chengdu, 610041, Sichuan, China.
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Gou J, Li Z, Liao X, Nie D, Xue L, Li L. Single-incision laparoscopic hysterectomy using conventional laparoscopic instruments: initial experience with 25 cases. Arch Gynecol Obstet 2018; 298:921-926. [PMID: 30132117 DOI: 10.1007/s00404-018-4858-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2018] [Accepted: 07/28/2018] [Indexed: 11/27/2022]
Abstract
PURPOSE To evaluate the feasibility and safety of single-incision laparoscopic hysterectomy using conventional instruments. METHODS Twenty-five patients undergoing single-incision laparoscopic hysterectomy (SI-LAH) using conventional instruments at West China Second University Hospital between July, 2017 and December, 2017 were selected for participation. Another 25 cases undergoing traditional multi-port laparoscopic hysterectomy (MP-LAH) matched with similar uterine size were selected as controls. Characteristics and clinical data of patients including operative time, estimated blood loss, hospital stay, catheter retention time, and intraoperative and postoperative complications were compared between the two groups. RESULTS The baseline characteristics of the two groups were comparable. The estimated blood loss was less in SI-LAH with respect to MP-LAH (30 mL [range 20-50] vs 50 mL [range 10-200], P < 0.05), with no statistically significant difference in terms of decrease of hemoglobin level (17 g/dL [range 2-24] vs 18 g/dL [range 5-28], P > 0.05). There were no significant differences between the two groups in terms of operative time (150 min [range 85-225] vs 145 min [range 100-220], P > 0.05), intraoperative injury, catheter retention time, time to exhausting, postoperative hospital stay. In all cases, no additional port incision was needed and no conversion to laparotomy was necessary in two groups. No patient had development of intraoperative or postoperative complications. After a follow-up of 2 months, no incisional hernia occurred in all patients. CONCLUSIONS Single-incision laparoscopic hysterectomy using conventional instruments is a feasible and safe technique for patients with uterine size less than 12 weeks of pregnancy and no serious pelvic adhesion, requiring for more experienced skill of surgeons.
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Affiliation(s)
- Jinhai Gou
- Department of Gynecology and Obstetrics, West China Second University Hospital, Sichuan University, Chengdu, 610041, Sichuan, People's Republic of China
- Key Laboratory of Obstetrics and Gynecologic and Pediatric Diseases and Birth Defects of Ministry of Education, West China Second Hospital, Sichuan University, Chengdu, 610041, Sichuan, People's Republic of China
| | - Zhengyu Li
- Department of Gynecology and Obstetrics, West China Second University Hospital, Sichuan University, Chengdu, 610041, Sichuan, People's Republic of China.
- Key Laboratory of Obstetrics and Gynecologic and Pediatric Diseases and Birth Defects of Ministry of Education, West China Second Hospital, Sichuan University, Chengdu, 610041, Sichuan, People's Republic of China.
| | - Xin Liao
- Department of Gynecology and Obstetrics, West China Second University Hospital, Sichuan University, Chengdu, 610041, Sichuan, People's Republic of China
- Key Laboratory of Obstetrics and Gynecologic and Pediatric Diseases and Birth Defects of Ministry of Education, West China Second Hospital, Sichuan University, Chengdu, 610041, Sichuan, People's Republic of China
| | - Dan Nie
- Department of Gynecology and Obstetrics, West China Second University Hospital, Sichuan University, Chengdu, 610041, Sichuan, People's Republic of China
- Key Laboratory of Obstetrics and Gynecologic and Pediatric Diseases and Birth Defects of Ministry of Education, West China Second Hospital, Sichuan University, Chengdu, 610041, Sichuan, People's Republic of China
| | - Luqi Xue
- Department of Gynecology and Obstetrics, West China Second University Hospital, Sichuan University, Chengdu, 610041, Sichuan, People's Republic of China
- Key Laboratory of Obstetrics and Gynecologic and Pediatric Diseases and Birth Defects of Ministry of Education, West China Second Hospital, Sichuan University, Chengdu, 610041, Sichuan, People's Republic of China
| | - Lin Li
- Department of Gynecology and Obstetrics, West China Second University Hospital, Sichuan University, Chengdu, 610041, Sichuan, People's Republic of China
- Key Laboratory of Obstetrics and Gynecologic and Pediatric Diseases and Birth Defects of Ministry of Education, West China Second Hospital, Sichuan University, Chengdu, 610041, Sichuan, People's Republic of China
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Ybañez-Morano J, Tiu AC. Synchronous single-port access laparoscopic right hemicolectomy and laparoscopic-assisted vaginal hysterectomy with bilateral salpingo-oophorectomy. J Surg Case Rep 2017; 2017:rjw236. [PMID: 28096321 PMCID: PMC5241908 DOI: 10.1093/jscr/rjw236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Laparoscopic surgery through a single incision is gaining popularity with different stakeholders. The advantages of improved cosmetics, decreased postoperative pain and blood loss continue to attract patients from different surgical fields. Multidisciplinary approach to different surgical entities through a single incision has just been introduced. We report the first case of a synchronous single-port access (SPA) laparoscopic right hemicolectomy and laparoscopic-assisted vaginal hysterectomy with bilateral salpingo-oophorectomy through a single incision above the umbilicus in a 48-year-old female with ascending colon mass and uterine mass with good postoperative outcomes. SPA laparoscopic surgery is feasible for multidisciplinary approach in resectable tumors.
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Affiliation(s)
- Jessica Ybañez-Morano
- Department of Obstetrics and Gynecology, Ohio Valley Medical Center - Valley Professional Center, Wheeling, WV 26003, USA
| | - Andrew C Tiu
- Department of Obstetrics and Gynecology, Ohio Valley Medical Center - Valley Professional Center, Wheeling, WV 26003, USA
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Single-port access versus conventional multi-port access total laparoscopic hysterectomy for very large uterus. Obstet Gynecol Sci 2015; 58:239-45. [PMID: 26023674 PMCID: PMC4444521 DOI: 10.5468/ogs.2015.58.3.239] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2014] [Revised: 10/08/2014] [Accepted: 10/10/2014] [Indexed: 12/27/2022] Open
Abstract
Objective The aim of this study was to compare the surgical outcomes of single-port access (SPA) and conventional multi-port access total laparoscopic hysterectomies (TLH) among patients with very large uteri (500 g or more). Methods Fifty consecutive patients who received TLH for large uterine myomas and/or adenomyoses weighing 500 g or more between February 2009 and December 2012 were retrospectively reviewed. SPA and conventional TLH were each performed in 25 patients. Surgical outcomes, including operation time, estimated blood loss, postoperative hemoglobin change, postoperative hospital stay, postoperative pain, and perioperative complications, were compared between the two groups. Results There were no significant demographic differences between the two groups. All operations were completed laparoscopically with no conversion to laparotomy. Total operation time, uterus weight, estimated blood loss, and postoperative hemoglobin change did not significantly differ between the two groups. Postoperative hospital stay was significantly shorter for the SPA-TLH group compared to that of the conventional TLH group (median [range], 3 [2.0-6.0] vs. 4 [3-7] days; P=0.004]. There were no inter-group differences in postoperative pain at 6, 24, and 72 hours after surgery. There was only one complicated case in each group. Conclusion SPA-TLH in patients with large uteri weighing 500 g or more is as feasible as conventional TLH. SPA-TLH is associated with shorter hospital stays compared to that of conventional TLH.
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