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Reduced‐port laparoscopic restorative proctocolectomy without diverting ileostomy
Author(s) -
Ueki Takashi,
Manabe Tatsuya,
Nagayoshi Kinuko,
Yanai Kosuke,
Moriyama Taiki,
Shimizu Shuji,
Tanaka Masao
Publication year - 2015
Publication title -
asian journal of endoscopic surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.372
H-Index - 18
eISSN - 1758-5910
pISSN - 1758-5902
DOI - 10.1111/ases.12201
Subject(s) - medicine , proctocolectomy , ileostomy , surgery , pouch , anastomosis , ulcerative colitis , stoma (medicine) , port (circuit theory) , disease , electrical engineering , engineering
Abstract Introduction We introduced a reduced‐port procedure for laparoscopic restorative proctocolectomy without diverting ileostomy for patients with familial adenomatous polyposis and ulcerative colitis. Materials and Surgical Technique A multichannel port was inserted through a 2.5‐cm umbilical incision. A 12‐mm port in the right lower abdomen and a 3‐ or 5‐mm port were also employed. A proctocolectomy was performed intracorporeally, and the entire colon and rectum were delivered through the umbilical incision. An ileal J‐pouch was made extracorporeally following division of the mesenteric vessels. Ileal j‐pouch–anal anastomosis was performed intracorporeally or transanally after rectal mucosectomy. A drain was inserted through the 12‐mm port incision, and a transanal decompression tube was placed in the pouch. Two women and one man underwent this surgery, and their postoperative recovery was uneventful. Discussion Laparoscopic restorative proctocolectomy without a diverting stoma by a reduced‐port technique is feasible and provides excellent cosmetic outcomes in selected patients.