Laparoscopic Total Colectomy With Transvaginal Removal of the Colon and Ileorectal Anastomosis

Ziad T Awad, MD FACS, Keyur Chavda. University o fFlorida College of Medicine – Jacksonville

 

40 year old female with lower GI bleeding. Colonoscopy showed 2 lesions (transverse and sigmoid colon), biopsies from both showed adenocarcinoma. CT scan showed large metastatic lesion at segment VIII liver (biopsy positive adenocarcinoma). PET scan showed another lesion at the back of the left lateral segment.

Five 5 mm and one 12 mm trocars were used. The whole colon was mobilized, the vessles were controlled with energy source. The terminal ileum and rectosigmoid junction were transected with laparoscopic linear stapler. Posterior colpotomy was made and wound protector was placed transvaginally. The whole colon was removed transvaginally. The anvil was placed transvaginally and the colpotomy was closed with few interrupted sutures of 0 vicryl. The ileorectal anastomosis was done intracorporeally.

Hospital stay 2 days. At 2 weeks postop. she was started on chemotherapy.

The transvaginal removal route may be used in selected cases of colon cancer femle patients. 

 


Session Number: SS17 – Videos: Colon
Program Number: V024

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