Feasibility, Safety and efficacy of 3-mm instruments in laparoscopic right hemicolectomy for cancer: preliminary experience

Abstract INTRODUCTION 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. METHODS 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). RESULTS 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). CONCLUSION 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.