D. Geisler and T. Garrett: Single incision laparoscopic colorectal surgery: a single surgeon experience of 102 consecutive cases

Excerpt

Single port surgery is gathering increasing attention in USA and abroad, witness that no comprehensive symposium on Minimally Invasive Colorectal Surgery fails to include the topic in its program. The present manuscript is the largest single authored or single institution study on the topic [1]. The evidence presented shows at least parity with all or most of the metrics used in measuring short-term outcomes after conventional laparoscopic surgery. However, as Dr. Bergamaschi’s editorial in this issue of Technique in Coloproctology points out [2], this study is a personal, uncontrolled series without clear inclusion and exclusion criteria. However, this was true for all early studies on laparoscopic colorectal surgery. Laparoscopic surgery for colorectal cancer, large randomized controlled trials took almost 10 years to accrue a critical mass for evaluation. So the best that can be done at this stage is a matched cohort study, which is for future work. As Dr Geisler agrees, there are other limitations to the study. No long-term outcome (i.e. port site hernia) is available, and even short-term outcome like pain control and patient satisfaction was not recorded. Intuitively one would expect these to be at the very least comparable if not superior to conventional laparoscopic colorectal surgery. Overall I think that the present contribution is a valuable addition to the discourse on this topic. …