EP1025 - Is single-port laparoscopic surgery safe and feasible in urgent conditions?
Single-port laparoscopic Hartmann’s procedure

Purpose/Background: Single-port laparoscopic surgery (SPLS) effectively improves aesthetics, while reducing wound morbidity for elective management of colon disease. However, its use for Hartmann's procedure in urgent conditions remains controversial. The aim of this study is to report our experience with the single-port laparoscopic Hartmann's procedure (SPLHP).

Methods/Interventions: Between June 2009 and April 2014, 48 patients underwent SPLHP for urgent conditions. SPLHP was performed transumbilically or through a predetermined stoma site. Conventional, straight, and rigid-type laparoscopic instruments were used. After intracorporeal, segmental resection of the affected colon, the specimen was extracted through the single-incision site. We then analyzed both operative outcomes and postoperative complications.

Results/Outcomes: SPLHP was performed in 15 patients for malignant and 33 for benign diseases (13, diverticular disease; eight, sigmoid volvulus; 5, anastomosis leakage; 7, others). In one patient (2.1%), conversion to open surgery was necessary. The median operative time and postoperative hospitalization period were 209 min (range, 85-385 min) and 13.5 days (range, 3-33 days), respectively. The median time to resume oral intake was 3.0 days (range, 1-11 days). Intra- and post-operative complication rates were 6.3% and 16.7%, respectively. There was one death within 30 days.

Conclusion/Discussion: SPLHP is safe and feasible in urgent conditions and may be considered an additional surgical option for experienced SPLS surgeons in select patients.

TABLE 1. DEMOGRAPHICS OF PATIENTS UNDERGOING SPLHP
ASA American Society of Anesthesiologists

*Others: rectovaginal fistula(2), local recurrence(1)


TABLE 2. OPERATIVE AND POST-OPERATIVE DATA OF PATIENTS UNDERGOING SPLHP