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Copyright ©The Author(s) 2016. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Jan 14, 2016; 22(2): 659-667
Published online Jan 14, 2016. doi: 10.3748/wjg.v22.i2.659
Review of 500 single incision laparoscopic colorectal surgery cases - Lessons learned
Deborah S Keller, Juan R Flores-Gonzalez, Sergio Ibarra, Eric M Haas
Deborah S Keller, Juan R Flores-Gonzalez, Sergio Ibarra, Eric M Haas, Colorectal Surgical Associates, Houston, TX 77054, United States
Deborah S Keller, Eric M Haas, Division of Colon and Rectal Surgery, Houston Methodist Hospital, Houston, Tx 77030, United States
Eric M Haas, Division of Minimally Invasive Surgery, Department of Surgery, The University of Texas Medical School at Houston, Houston, TX 77054, United States
Author contributions: Keller DS contributed to conception and design of the study, acquisition of data, analysis and interpretation of data; drafting the article, critical analysis; approval of final version; Flores-Gonzalez JR, Ibarra S contributed to acquisition of data, analysis of data, drafting the article; approval of final version; Haas EM contributed to conception and design of the study, analysis and interpretation of data, critical analysis, approval of final version.
Conflict-of-interest statement: There is no conflict of interest associated with any of the authors on this manuscript.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Deborah S Keller, MS, MD, Colorectal Surgical Associates, LLP LTD, 7900 Fannin Street, 2700, Houston, TX 77054, United States. debby_keller@hotmail.com
Telephone: +1-713-7900600 Fax: +1-713-7900616
Received: July 2, 2015
Peer-review started: July 6, 2015
First decision: August 26, 2015
Revised: September 9, 2015
Accepted: November 19, 2015
Article in press: November 19, 2015
Published online: January 14, 2016
Abstract

Single incision laparoscopic surgery (SILS) is a minimally invasive platform with specific benefits over traditional multiport laparoscopic surgery. The safety and feasibility of SILS has been proven, and the applications continue to grow with experience. After 500 cases at a high-volume, single-institution, we were able to standardize instrumentation and operative steps, as well as develop adaptations in technique to help overcome technical and ergonomic challenges. These technical adaptations have allowed the successful application of SILS to technically difficult patient populations, such as pelvic cases, inflammatory bowel disease cases, and high body mass index patients. This review is a frame of reference for the application and wider integration of the single incision laparoscopic platform in colorectal surgery.

Keywords: Laparoscopic colectomy, Minimally invasive colorectal surgery, Single-incision laparoscopic surgery

Core tip: As the surgery paradigm progresses towards natural orifice transluminal endoscopic surgery, single incision laparoscopic surgery (SILS) is a valuable minimally invasive platform with specific clinical benefits. After experience from 500 SILS cases, we were able to standardize instrumentation and operative steps, and have developed technical adaptations for successful application in difficult patient populations. This review is a frame of reference for the application and wider integration of the single incision laparoscopic platform in colorectal surgery.