Reduced‐port laparoscopic restorative proctocolectomy without diverting ileostomy. Issue 4 (November 2015)

• Record Type: Journal Article
• Authors: Ueki, Takashi; Manabe, Tatsuya; Nagayoshi, Kinuko; Yanai, Kosuke; Moriyama, Taiki; Shimizu, Shuji; Tanaka, Masao
• Is Part Of: Asian journal of endoscopic surgery. Volume 8:Issue 4(2015:Nov.)
• Page Start: 487
• Page End: 490
• Publication Date: 2015-11
• Subjects: One‐stage operation -- reduced‐port surgery -- restorative proctocolectomy; Endoscopic surgery -- Periodicals; Endoscopic surgery -- Asia -- Periodicals; 617.05705
• DOI: 10.1111/ases.12201
• Languages: English
• ISSNs: 1758-5902

Abstract

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.