Surgeons at the University of California, San Diego School of Medicine report what is believed to be the nation's first single-incision laparoscopy to perform a combined colectomy and kidney-preserving therapy.
During the procedure, tumors were removed from the patient's kidney and colon, and the colon was partially removed and reconstructed. Pioneers in minimally invasive surgery, UC San Diego Medical Center's team of urologic and colorectal surgeons now use this novel micro-incision approach to combine multiple procedures into one operating room visit.
"Traditionally, these procedures are performed in separate operations," said Elisabeth C. McLemore, MD, colorectal surgeon at UC San Diego Medical Center and Moores UCSD Cancer Center. "To do what's best for the patient, we have integrated our approach so that the patient can benefit from multiple procedures with one small incision. This means less pain, a quicker recovery and a better cosmetic outcome."
During the four-hour procedure, surgeons immobilized the small intestine, colon and kidney. Cryotherapy was performed to freeze and destroy a 2.5 cm kidney mass. The section of diseased colon was then removed and reconstructed. The entire procedure was performed with one incision in the belly button through which tools and cameras were passed and diseased tissue removed. The patient, who suffers from congestive heart failure and high blood pressure, reported a post-surgery pain score of one on a scale of 1 to 10.
"With our broad experience in single incision laparoscopic surgeries, we can offer patients with complex medical problems an innovative approach that requires fewer incisions," said Ithaar Derweesh, MD, urologic oncologist at UC San Diego Medical Center and Moores UCSD Cancer Center. "While multi-incision laparoscopy confers significant benefits over open surgery, reducing the number of incisions to one may decrease potential complications and accelerate recovery."
Derweesh, a pioneer in single-incision surgery, is currently researching the benefits of minimally invasive techniques for kidney surgery through the UC San Diego Center for the Future of Surgery. He was the first surgeon in California to perform both complete and partial nephrectomies with a single incision and now has a robust practice offering both. McLemore, the most recent member of the Center, is developing minimally invasive techniques for colorectal cancer and inflammatory bowel disease.
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