Single port restorative intestinal minimally-invasive end-colostomy takedown: technique and first outcomes

Introduction. A trend toward reducing the invasiveness of surgical interventions is observed in colorectal surgery. Single-incision laparoscopic surgery (SILS) offers advantages over multiport and open approaches; however, its application in terminal stoma takedown remains insufficiently investigated. We present our first experience with this technique.
The purpose of the study. To evaluate the short-term outcomes of reconstructive restorative surgeries for end stoma closure via a single-port access.
Materials and Methods. Outcomes of reconstructive procedures in 13 patients (2023–2026) were analyzed. Inclusion criteria were: terminal colostomy or ileostomy, age ≥18 years, and elective surgery. Exclusion criteria comprised emergency procedures, decompensated comorbidities, and distal stump insufficiency. All patients underwent stoma closure via SILS. A mechanical stapled anastomosis was constructed in most cases, whereas two patients underwent hand-sewn extracorporeal anastomosis. Operative time, blood loss, pain severity, complications, and hospital stay were assessed.
Results. Mean age was 61,23 ± 11,92 years, and BMI (Me [Q1–Q3] was 25,60 [23,70 – 28,60] kg/m². Primary diagnoses were colorectal cancer (76,9 %) and diverticular disease (23,1 %). Parastomal hernia was identified in 38,5%. Mean operative time was 198,85 ± 68,35 min, and mean blood loss was 51,53 ± 42,39 mL. Pain scores on the visual analog scale (VAS) averaged 3 points on postoperative day 1 and 0 at discharge. Additional trocar placement was required in 15,4 % of cases. Complications included anastomotic stricture in one patient (7,7 %); no anastomotic leakage occurred. Mean postoperative hospital stay was 6,31 ± 1,60 days.
Conclusions. Stoma reversal utilizing a single-port access system through the stoma site represents can be a viable alternative to open and multiport approaches, as it is associated with minimal blood loss, moderate postoperative pain, and an acceptable complication rate, thereby demonstrating both efficacy and safety.

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