Single-port laparoscopic access for Crohnʼs disease complicated by enterocutaneous fistula

LETTER TO THE EDITOR

Single-Port Laparoscopic Access for Crohn’s Disease Complicated by Enterocutaneous Fistula To the Editor: Single-port laparoscopic surgery represents the new frontier of minimally invasive surgery. Conventional laparoscopy allows for significant improvements in short-term postoperative outcomes, with low morbidity and better esthetic results compared with open surgery in the treatment of ileocolic Crohn’s disease (CD).1 Reports of right and left single-port colectomy for early neoplasia and diverticular disease were published first by Bucher and Leroy,2,3 whereas only 1 report of complicated CD, successfully treated with single laparoscopic access, has been described, by Heeney.4 We report a case of ileocecal resection with single laparoscopic access for ileocolic CD complicated by enterocutaneous fistula. A 27-year-old male patient was referred in October 2009 to our institution for chronic enterocutaneous fistula at the site of a previous surgical skin incision. Four months before, he had consulted the emergency department of a secondary general hospital for acute abdominal pain in the right iliac fossa associated with fever and moderate leukocytosis. He was brought to the operating room for suspected appendicitis. A McBurney’s incision was performed, and CD was diagnosed intraoperatively. The appendix was not removed. The immediate postoperative course was uneventful. The patient was referred to a specialized gastroenterologist but 3 weeks later developed a wound abscess at the surgical site. A low output (