Frequently Asked Questions
Answered by Dr. Deborah Nagle
Commonly asked questions answered by
Dr. Deborah Nagle, Chief of Colon and Rectal Surgery at Beth Israel Deaconess Medical Center.
What is single incision laparoscopic colectomy?
Single incision laparaoscopic colectomy is a new technique to remove all or part of the colon. It involves just one small (about 1 inch or slightly longer) incision made at the belly button. Surgeons are able to thread the necessary instrumentation through that one port to complete the operation.
How does this new technique differ from other colon removal techniques?
There are two other types of colon surgery. The more traditional form is an open surgery which involves a large (6 inch or larger) incision across the abdomen. The other is a minimally invasive procedure called laparoscopic colectomy. In that procedure, surgeons make 3 to 4 smaller incisions in different parts of the abdomen and thread a tiny camera and other instruments to the impacted area to perform the surgery. This newer technique uses just one incision to accomplish the same result.
What are the benefits of this technique?
The fewer incisions, the less chance of complications such as bleeding and infection and hernia. Many patients also experience less pain and as a result, a quicker recovery. Some patients leave the hospital on the first day after surgery. Many patients say the best part is that they have just one tiny scar (or in some cases, no visible scar) ) instead of a series of scars or one big scar.
Who is a candidate for this technique?
Many patients are a candidate for this technique. We commonly offer this approach to patients who have elective, or non-urgent surgery. We do offer it to patients who have had previous surgery under some circumstances. Generally, anyone who is a candidate for any laparoscopic colectomy would be a candidate for single incision colectomy.
What are the risks?
Any surgical procedure has risks. All procedures have the risk of bleeding and infection. Bleeding complications requiring blood transfusion are very rare in laparoscopic colorectal surgery. Infection is our most common problem. Even with the best preparation, the risk of infection is about 7%. We are below national targets in this regard. All surgery has some pain associated with it. There are rare complications such as leakage from the bowel hook-up and injury to other organs . Every surgery creates some kind of scar, no matter how tiny. Studies have shown that generally, laparoscopic procedures result in quicker return to normal activity compared with open surgery. While this newer technique has yet to undergo large or long-term studies early evaluation shows that it leads to similar positive results.
How long will I be in the hospital?
Most patients who undergo uncomplicated laparoscopic colon surgery are home within 2 to 3 days. Patients who have single incision laparoscopic surgery may go home in 1 day. We always emphasize to our patients that it is not the number of days in the hospital that counts - it is when you are ready to go home. We have several criteria to determine readiness to go home. In general, younger patients go home more quickly than older patients.
Are there any added costs and will my insurance cover them?
There are no extra costs with this technique.
Are all surgeons offering this technique?
Only a few programs nationwide offer single incision surgery for the colon. Beth Israel Deaconess was among the first in the country to use this technique and remains one of the most experienced at its use. Our doctors are helping to train others so it can be offered more widely. The same patient-centered care than is the emblem of BIDMC practice guides every decision we make about surgery and post-operative care.
Posted February 2010