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INTRODUCTION: Single site surgery is rapidly gaining popularity for its cosmetic benefits. However it requires immense technical skill due to its challenging ergonomics.We have reported here a case where multiple surgeries have been performed through the same single site,without the usage of special devices.This article has been reported in line with the SCARE criteria [1]. PRESENTATION OF CASE: A 45-year-old obese lady presented with symptomatic cholelithiasis and a para umbilical hernia. She underwent uneventful trans umbilical, single site laparoscopic cholecystectomy, sleeve gastrectomy and paraumbilical hernia repair. DISCUSSION: This article is being published as it is the first reported from the Middle East. Recent development of laparoscopy was represented with introduction of the concept of scarless surgery using Natural Orifice Transluminal Endoscopic Surgery (NOTES), or its Transumbilical counterpart (NOTUS). Unfortunately,these two approaches have not been widely reported, probably due to the need for specialized instruments, learning curve, and prolonged surgery time [2]. CONCLUSION: This single case report is to indicate that it is technically possible and cosmetically appealing to perform such a complex surgery.
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Background: This study represents a prospective analysis of a series of laparoscopic ultra low anterior resection (ULAR) done at a laparoscopic surgical center to assess the surgical outcome, oncological efficacy, and quality of life after surgery. Methods: Over a period of 6 years (2013-2018), 43 patients aged between 40 and 68 years, with very low rectal cancers (3-6 cm from the anal verge), within T3N1M0 stage, assessed by positron emission tomography-computed tomography and pelvic magnetic resonance imaging, underwent neoadjuvant chemoradiotherapy (nCRT) followed by laparoscopic ULAR and simultaneous diversion ileostomy. Results: The overall complication rate was low and there was an overall leak rate of 9.3% with a radiological leak (Grade A) in 3 of the 43 patients (7%), but only 1 (2.3%) patient required a local lavage and a resuturing for secondary hemorrhage. Recurrence was seen in 2/43 (4.7%), one of whom had a conversion to abdominoperineal resection. The other had distant metastasis and refused further treatment. The functional outcome is assessed in 41 (95.3%) patients by low anterior resection syndrome (LARS) score and a reasonable quality of life with major LARS was seen in only 7.3% of the patients at a follow-up ranging from 1 to 6 years. Conclusion: The nCRT followed by laparoscopic ULAR is a feasible option for operable very low rectal cancers and is associated with minimal postoperative events, a low local recurrence and less incidence of LARS.