Building upon the momentum and success of its rapidly growing single-incision laparoscopic surgery program, Saint Louis University Hospital recently performed one of the first total abdominal colectomies, including reconstruction of the intestinal tract by reconnection of the remaining small intestine to the rectum, via single-incision laparoscopy. This procedure is a critical advancement in minimally-invasive surgery.
Ovunc Bardakcioglu, M.D., a gastrointestinal surgeon at SLU Hospital and director of the hospital's single-incision laparoscopic program, performed the procedure on a 64-year-old male with colon cancer, extracting approximately 40 inches of colon through a four-centimeter incision below the bellybutton region. The patient was discharged home just four days after surgery and has not experienced any immediate postoperative complications.
"A laparoscopic total colectomy is already one of the most advanced and difficult laparoscopic procedures working with a large organ in all quadrants of the abdomen," says Dr. Bardakcioglu. "Performing this procedure using a single incision is an even greater challenge. However, it's advancing gastrointestinal surgery as we know it, providing benefits for our patients."
Currently, single-incision laparoscopy is performed for basic laparoscopic procedures involving single abdominal quadrants, such as appendectomies, gall bladder removals and, more recently, partial colectomies. This total colectomy case indicates that single-incision laparoscopic techniques can be utilized for more complex abdominal laparoscopic procedures with a large organ and a working space involving all quadrants of the abdominal cavity. Some of these techniques may be applied and further adapted for colonic resection via a natural orifice in the future. More importantly, this procedure is a major step towards natural orifice colectomies.