We greatly appreciate Huscher and colleagues' interest in our work and congratulate them on their series of single-incision laparoscopic operations using conventional instrumentation. We understand fully that expert, extremely skilled surgeons like this group in Rome can accomplish significant technical feats while maintaining high-level clinical and oncologic outcomes. We would comment in return that in developing our own technique, we focused on ensuring that a highly standardized protocol emerged for each operative step in sequence so that the procedure could be reproducibly performed. We believe that the new generation of technical equipment now becoming available should be used to move single-port access for relatively complex operations such as sigmoidectomy into the realm of the typical general surgeon rather than becoming the preserve of a few exceptionally talented individuals.
Cahill RA, Leroy J, Asakuma M, Dallemagne B, Marescaux J. Feasibility of Colonic and Gastric Standard Laparoscopic Procedures With a Single Skin Incision Approach—Reply. Arch Surg. 2009;144(10):977-980. doi:10.1001/archsurg.2009.169