Transanal single port access to facilitate distal rectal mobilization in laparoscopic rectal sleeve resection with hand-sewn coloanal anastomosis.

Autor: Wolthuis AM; Department of Abdominal Surgery, University Hospital Gasthuisberg, Herestraat 49, 3000 Leuven, Belgium. albert.wolthuis@uzleuven.be, Cini C, Penninckx F, D'Hoore A
Jazyk: angličtina
Zdroj: Techniques in coloproctology [Tech Coloproctol] 2012 Apr; Vol. 16 (2), pp. 161-5. Date of Electronic Publication: 2011 Dec 15.
DOI: 10.1007/s10151-011-0795-0
Abstrakt: Background: Laparoscopic rectal sleeve resection is challenging and technically demanding. Exposure and mobilization of the most distal part of the rectum can be especially hazardous. We propose the use of a single port access device, placed in the anal canal after incision of the sleeve at the appropriate level, to facilitate dissection without sphincter damage. The case of a 51-year-old woman suffering from a recurrent supralevator abscess is presented to illustrate the technique.
Methods: The procedure consisted of laparoscopic rectal pull-through with rectal sleeve resection and coloanal anastomosis. Incision of the endopelvic fascia and mobilization of the distal mesorectum was performed via the single port device under direct control. Medial-to-lateral mobilization of the colon was performed with a 3-port technique.
Results: Total operating time was 122 min: 50 min for rectal mobilization, 42 min for the laparoscopic part of the procedure and 30 min for the coloanal anastomosis. The patient's recovery was uneventful, and at 1-month follow-up, she was asymptomatic.
Conclusions: Laparoscopic-assisted transanal single port rectal mobilization seems to be a promising addition to the armamentarium of minimally invasive surgery.
(© Springer-Verlag 2011)
Databáze: MEDLINE
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