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Single incision laparoscopic total proctocolectomy with ileopouch anal anastomosis
Author(s) -
Geisler D. P.,
Condon E. T.,
Remzi F. H.
Publication year - 2010
Publication title -
colorectal disease
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.029
H-Index - 89
eISSN - 1463-1318
pISSN - 1462-8910
DOI - 10.1111/j.1463-1318.2009.02115.x
Subject(s) - medicine , ileostomy , pouch , surgery , anastomosis , proctocolectomy , rectum , laparoscopy , colorectal surgery , abdomen , colonoscopy , general surgery , ulcerative colitis , abdominal surgery , colorectal cancer , disease , cancer
Aim We present our initial experience of a single port laparoscopic total proctocolectomy with ileoanal J pouch anastomosis. The single incision laparoscopic surgery (SIL), (Covidien, Norwalk, Connecticut, USA) device with a multichannel cannula and specially designed curved laparoscopic instrumentation were used. Method A patient with familial adenomatous polyposis underwent restorative proctocoectomy. A colonoscopy had demonstrated nearly 1000 polyps in the colon with several 1‐cm polyps in the rectum. The abdomen was entered through a 2.5 cm incision sited preoperatively for the temporary ileostomy. The single port device was inserted and a total proctocolectomy was performed. Ligation of the vessels was performed with the Ligasure (Covidien). The colon and rectum were extracted through the SIL site. An 18‐cm ileoanal J pouch was created extracorporeally. The pouch anal anastomosis was performed intracorporeally and a diverting loop ileostomy created through the SIL port site. Results The operating time was 172 min. Blood loss was 100 ml and the hospital stay was 4 days without any complication. The patient had a virtually scar‐less abdomen other than the site of the loop ileostomy. Conclusion Single port laparoscopic surgery may allow complex colorectal surgery to be performed resulting in a virtually scar‐less procedure.