Surgical procedure
tumor
TUMOR, CAVITY, SILS
Both SILS + 1 and CLS were complied with the same principles of the operative extent by surgeons who had completed over 100 successful CLS cases and at least 10 successful SILS + 1 cases.For the SILS + 1 procedure, a multiport device (SURGAID MEDICAL; XIAMEN, CHINA) was placed at a 5-cm periumbilical transverse incision and an additional 12-mm trocar was placed in the right lower quadrant served as the surgeon’s dominant operating channel. After mobilization, the specimen was retrieved through the primary incision where the SILS device was placed. After surgery, a drainage tube was inserted through the trocar incision to drain the pelvic cavity if the patients underwent anterior resection. The decision to add trocar(s) was made at the surgeon’s discretion and was defined as conversion to multiport surgery.The CLS procedure was performed using 5 trocars placed in the regular position as described previously. After mobilization, the specimen was extracted through the umbilical incision which was transversely extended to 4-5 cm according to the tumor size. Once the length of the minilaparotomy exceeded 10 cm, laparoscopic surgery was considered as the conversion to open surgery.For both approaches, surgical quality control was maintained by using mandatory intraoperative photographs that identified specific surgical fields, the resection margin of the specimen, and the abdominal incision. Five photos were used to verify the surgical quality, as follows: [