Minimally Invasive Hemicolon Excision-Radical Approach

Aim: This is a presentation of the Single Incision hemicolon resection in an obese patient, suffering from cecal polyp, which could not be excisied endoscopically. Intervention: It was a SILS procedure with standard tools: 5 mm flexible laparoscope, straight and articulatinng grasper and LigaSure device. The intervention plan was followed step by step. Once ileo-colic pedicle exposed, duodenum was found and ileo-colic vein and artery were cut with a stapler. The next step was the greater omentum dissection with help of LigaSure. Then, hepatic flexion was moved and mesocolon was separated. Pelvic attachement of the cecum and illeum were excised and the whole colon was liberated. Kidney, duodenum and the right ureter were identified. The resected bowler was taken out and continuity of the interstinal duct was provided before wound closure. Results: There wasn't any complication after the procedure. Incision length 3,5 cm. Histological report did not show any signs of cancerogenesis and 20 lymph nodes resulted negative for cancer. Conclusions: The presented method is safe, applicable and all the Laparoscopic Single Incision Surgery bases were fulfilled. Authors: Eugene Rubach, MD, Matthew Ostrowitz, MD, George DeNoto, MD, Gary Gecelter, MD