Maen Aboul Hosn, MD, Faek R. Jamali, MD, FSSO, Ramzi Alami, MD
Division of General Surgery, Department of Surgery, American University of Beirut, Beirut, Lebanon (all authors).
Introduction: Single-incision laparoscopic surgery has gained popularity in recent years with an increasing number of complicated procedures being performed using this approach. Single-port total colectomy has been reported in the literature mainly in the setting of inflammatory bowel disease and polyposis. We report on a young patient who underwent single-port abdominal colectomy for transverse colon cancer along with multiple colonic polyps.
Case Description: A 33-year-old female presented initially with a vague abdominal pain. Her workup included a colonoscopy that showed multiple colonic polyps with a circumferential fungating lesion in the transverse colon. This lesion was biopsied and found to be positive for moderately differentiated adenocarcinoma of the colon. With these findings, the patient was advised about the different surgical options, and the decision was made to go for abdominal colectomy with ileorectal anastomosis. Given this patient’s low BMI and favorable body habitus, the procedure was performed with a single-port technique through a small umbilical incision. There were no perioperative complications, and the final pathologic examination revealed a 5-cm invasive moderately differentiated carcinoma extending through the muscularis propria into pericolonic fat and multiple colonic tubulovillous adenomas along with 22 regional lymph nodes draining the basin of the distal transverse colon, all of which were negative for malignancy.
Conclusion: Single-port laparoscopic total colectomy for colon cancer in carefully selected patients and in the hands of a fully trained laparoscopic surgeon is feasible and appears to offer more cosmetic benefits than conventional laparoscopic colectomy, with similar short-term and oncological outcomes.
Key Words: Single-port total colectomy, Single-incision surgery, Colon cancer, Laparoscopic total colectomy