Abstract
Al Sabah et al. 1 review 20 patients who underwent colorectal surgery using the single-port technique. The article reviews their initial experience and points out that patients were carefully selected. This is underscored by the fact that the majority of their patients had right colon resection and that the average body mass index was 25 kg/m2. The report supports their review of a safe operation, reasonable operative time, and appropriate oncologic yield. The issue left unanswered is how this single-port technique at their institution compares with the core standard minimally invasive technique of laparoscopic colon resection. The given advantage of single-port laparoscopy is its cosmetic benefit of one incision. The authors have not answered the more important question of cost containment and the cost of extra instrumentation for the single-port procedure. This is a crucial issue and will become even more important with healthcare changes in the future.
That said, new procedures will find their place in a cost-contained healthcare system and deserve being reported and discussed. Single-port laparoscopic instrumentation has already shown us a new technique of transanal extraction of lesions that may be less expensive than other transanal equipment.
I would encourage the authors to expand their initial article to a comparison study with their standard laparoscopic colon resection cases or to conduct a randomized study to look at all issues of treatment and costs. It is hoped that this single-port technique will find a select segment of treatment that benefits all patients and promotes cost-contained surgical practice.