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October 19, 2009

Feasibility of Colonic and Gastric Standard Laparoscopic Procedures With a Single Skin Incision Approach

Arch Surg. 2009;144(10):977-980. doi:10.1001/archsurg.2009.168

We read with great interest the article by Leroy et al1 about their innovative single-access laparoscopic sigmoidectomy for diverticulitis. The rationale for this minimally invasive procedure is the improved cosmetic results; the potential decrease in morbidity related to visceral and vascular injuries during trocar placement; and the lower risk of postoperative wound infection, hernia formation, and pain. By using technical innovations like umbilical, multichannel, single-port, magnetic anchoring; roticulated graspers; and intraluminal assistance for traction, they performed a sigmoidectomy for diverticulitis via a 2-cm single skin incision. However, because of the difficulty in performing full mesenteric dissections, they consider this procedure unsuitable for oncologic resections.