Effort to standardize single incision laparoscopic colectomy for right-sided colon cancerOutstanding Poster Award

Objective: Surgeons should aware of laparoscopic-surgery specific weaknesses to accomplish adequate procedures. Vessels belong to right colon are vary in each patient. To overcome these weaknesses, secure visualizations of diagnostic image for navigation surgery have one strong possibility. We present our own effort not only to overcome these weaknesses but also to standardize the single incision laparoscopic colectomy (SLC) for right-sided colon cancer. Methods: 3-dimentional (3D)-triple fusion virtual images, which were constructed from multi-directional computed tomography/positron emission tomography and air-colonography, were routinely obtained for decision of operative strategy. Moreover, by using this image for navigation surgery, surgeons could perform dissection which thought to be indispensable for curative resection for colon cancer. Results: From 2008 to 2014, 202 patients with right-sided colon cancer were undergone laparoscopic surgery. When divided into three period (Period I: 2008~2009, N = 56, Period II: 2009~2010; N = 70, Period III:2011~2014; N = 76), percentage of SLC were significantly increased (p<0.05, ANOVA). No significant change in short term outcome and significant increase in number of sampled lymph nodes (p<0.05, ANOVA) were observed in each period.Conclusions: 3D-triple fusion virtual images are potentially useful not only to overcome laparoscopic surgery specific weaknesses but also to standardize SLC for right-sided colon cancer.