Combined Single Port and Reduced Port Procedures: “One size fits all”

B. Widmann, S. Bischofberger, L. Traine, A. Rossetti, W. Brunner

Objective

Single Port (SP) surgery allows the performance of a variety of procedures by one standardised incision. Procedures in different quadrants of the abdomen can easily be combined via the same solely incision. Additional trocar placement can be reduced.

Methods

This is a retrospective analysis of a prospective auditable SP database. All patients undergoing a SP procedure with surgical sites in different regions of the abdomen (combined procedures) between July 2011 and January 2014 were included.

Results

Out of a total amount of 1040 patients undergoing 1197 single port procedures, in 34 patients (17 female, 17 male, age 58(15-91) , BMI 25(17-30)) 69 combined surgical procedures were performed (21 cholecystectomies, 14 hernia repairs, 16 colon/rectal resections, 8 appendectomies, 4 adnexal surgeries, 6 others). 11 (32%) had preoperative surgery. The mean hospital stay was 5 days (range: 2-17 days). Additional trocars were used in 17 (50%), mostly due to adhesiolysis or triangulation and only necessary for one of the procedures in the perfect position. Two times drains were used. No conversion to open surgery was required. The post-operative mortality was 0, overall morbidity was 15% with a reoperation rate of 5.9% (bleeding, leakage).

Conclusion

SP approach offers access to all quadrants in the abdomen. Different procedures can be combined without increasing the number of necessary trocars.