Single-incision Laparoscopic Surgery for Simultaneous Appendectomy and Cholecystectomy

Single-incision laparoscopic surgery (SILS) has become popular due to the advantage of minimizing surgical. We report on two cases of simultaneous appendectomy and cholecystectomy using a single-incision laparoscopic technique. The patients were 49- and 50-year old females diagnosed with acute appendicitis with concomitant cholelithiasis. Body mass indices of the patients were 22.3 and 26.0. A 3 cm abdominal incision was made via the umbilicus, and a single port platform was created using a small wound retractor (ALEXIS(R) wound retractor S, Applied Medical, Santa Margarita, CA, USA) and a surgical glove. Cholecystectomy was performed first, followed by the appendectomy. The operation times were 165 and 280 minutes, and blood loss was 50 and 150 cc, respectively. The postoperative hospital stays were five and seven days, and one patient had a wound seroma as a surgical complication. We believe that SILS for simultaneous appendectomy and cholecystectomy is a feasible and safe minimally invasive procedure.

Single-incision Laparoscopic Surgery for Simultaneous Appendectomy and Cholecystectomy

Single-incision laparoscopic surgery (SILS) has become popular due to the advantage of minimizing surgical. We report on two cases of simultaneous appendectomy and cholecystectomy using a single-incision laparoscopic technique. The patients were 49- and 50-year old females diagnosed with acute appendicitis with concomitant cholelithiasis. Body mass indices of the patients were 22.3 and 26.0. A 3 cm abdominal incision was made via the umbilicus, and a single port platform was created using a small wound retractor (ALEXIS(R) wound retractor S, Applied Medical, Santa Margarita, CA, USA) and a surgical glove. Cholecystectomy was performed first, followed by the appendectomy. The operation times were 165 and 280 minutes, and blood loss was 50 and 150 cc, respectively. The postoperative hospital stays were five and seven days, and one patient had a wound seroma as a surgical complication. We believe that SILS for simultaneous appendectomy and cholecystectomy is a feasible and safe minimally invasive procedure.

Comparison of a Straight, a Coloplasty, and a Colonic J-pouch Anastomosis after a Proctectomy for Rectal Cancer

PURPOSE: Colonic pouches have been used to improve the reservoir function of the neorectrum after a ultra-low anterior resection for treatment of rectal cancer. The purpose of this study was to compare the safety and the functional outcome between a straight anastomosis, an anastomosis using coloplasty, and that using a colonic J-pouch in patients who had undergone an ultralow anterior resection. METHODS: From 2004 through 2006, 60 patients underwent a coloanal straight (straight group: n=23), coloplasty (coloplasty group: n=19), or colonic J-pouch (J-pouch group: n=18) anastomosis to the anal canal after a total mesorectal excision of the rectal cancer. We retrospectively reviewed the medical records of those patients for clinical outcomes according to the reservoir type. The median follow-up interval was 23.7 (4.4-40.9) mo. RESULTS: The anastomotic leakage rate was higher in the coloplasty group (21.1%) than in the straight group (8.7%) or in the J-pouch group (0%), but the difference was not significant (P=0.1). The mean number of bowel movements per day was significantly lower in the coloplasty group (3.6) and in the pouch group (3.1) than in the straight group (6.2) (P=0.015). No statistically significant differences were found among the three groups regarding other functional outcomes, including use of antidiarrheal drugs (P=0.971), gas incontinence (P=0.256), fecal incontinence (P=0.544), use of pads (P=0.782), difficulty of evacuation (P=0.496), and use of enemas (P=0.712). CONCLUSION: Reconstruction with a coloplasty or a colonic J-pouch in patients undergoing a low colorectal or coloanal anastomosis after rectal cancer surgery seems to decrease the number of daily bowel movements compared to a straight anastomosis. However, the anastomotic leakage rate of coloplasty group was higher than that of the straight-anastomosis group.