Document Type : Research/Original Article
Department of Surgery, Policlinico San Pietro, Ponte San Pietro, Bergamo, Italy.
Department of Surgery, Policlinico San Pietro, Ponte San Pietro, Bergamo, Italy
Nowadays, the evolution of technology has made available instruments of very small caliber without affecting the surgical technique. Mini-laparoscopy (m-Lap) right hemicolectomy is an evolution of classic laparoscopy (c-Lap), consisting of three-port laparoscopic surgery using a 3-mm trocar.
A retrospective analysis of a prospectively constructed database was performed to assess the feasibility, safety, and efficacy of 3-mm instruments. We included patients undergoing a right hemicolectomy with c-Lap or m-Lap for cancer. Patients undergoing emergency, palliative, or open surgery were excluded. Primary outcomes were the rate of anastomotic leakage (AL), surgical site infection (iSSI), organ/space infection (OSI), and disease-free and overall survival. Secondary outcomes were the length of surgery and length of stay (LOS).
Between January 2015 and December 2020, seventy-five patients met the inclusion and exclusion criteria. Among them, 20 (26,67%) underwent m-Lap and 55 (73,33%) underwent c-Lap. The two groups had homogeneous baseline characteristics. There were no differences in AL (P=0.905), iSSI or OSI (P=0.831), disease-free survival (P=0.340), overall survival (P=0.351), length of surgery (P=0.742), or length of hospital stay (P=0.053).
A 3-mm trocar for right hemicolectomy is feasible, safe, and effective. It does not affect the quality of surgery or the short and long-term outcomes. We hope this study will stimulate further research on less invasive surgical instruments.