Single Incision Total Proctocolectomy With Ileostomy

C Palanivelu, P Senthilnathan, P Praveen Raj, R Parthasarthi, S Rajapandian, Anand Vijai, Anirudh Vij. GEM Hospital & Research Centre

 

Background:
With the rapid emergence of Single Incision Surgeries, we now know this technique can be applied even to advanced procedures. Only drawback is additional cost of specialized trocars and instrumentation. Here we demonstrate our technique of Single Incision Total Proctocolectomy with Ileal pouch anal anastomosis without the need for specialised trocars and instruments
Video:
In this High Definition video we demonstrate our technique of Single Incision Total Proctocolectomy with Ileal pouch anal anastomosis and protective ileostomy
The steps are as follows:
– 2.5 cm incision is made at umbilicus, flaps raised to accommodate three trocars.
– Pneumoperitoneum using the Veress needle.
– Placement of trocars: one 10 mm and three 5 mm regular trocars at distance of 1 cm between each other.
– Mobilization of the hepatic flexure , the ascending colon, caecum and terminal ileum with the surgeon changing position
– Mobilization of the rectum completely followed by mobilisation of the splenic flexure and transverse colon.
-Division of lower rectum beyond the level of levator ani using reticulating endo GIA stapler.
– Specimen retrieval and pouch formation is done through umbilical ports
– Creation of ileal pouch anal anastomosis done.
– Fashioning of the Ileostomy
Conclusion;
Total Proctocolectomy through single incision laparoscopic surgery is very much feasible using conventional laparoscopic instruments and trocars. .


Session Number: VidTV2 – Video Channel Rotation Day 2
Program Number: V108

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