Mohamed Aboulkacem Bourguiba, MD1, Alaeddine Khemir2, Atef Ben Taher2, Faten Souai2. 1Faculty of Medecine of Tunis. University Tunis el Manar, 2Department of surgery A Charles Nicolle hospital Tunis Tunisia
Aim: We want to highlight the feasibility of a sigmoidectomy using total laparoscopic with a transanal extraction of the specimen.
Methods: it is a 34-year-old female patient, obese (BMI = 34 kg/m2) to the antecedents of laparoscopic cholecystectomy and chronic constipation. she was treated three months ago for a sigmoidal diverticulitis complicated with a pelvic abscess. the evolution has been favorable under antibiotic therapy and percutaneous drainage of the abscess. The Colonoscopy showed a multiple diverticula located between 20 and 25 cm from the anal verge. prophylactic sigmoidectomy was performed laparoscopically using 3 trocars (10 mm supra ombilical, 12 mm FID and 5 mm right flank). The specimen was extracted transanally, thus avoiding a pubic incision. The steps of the intervention were: 1- mobilisation of left colon 2- closing of distal left colon stump 3- rectal stump lavage 4- opening on the rectum 5-transanal introduction of the anvil 6-specimen transanal extraction 7- closing og rectal stump 8-colonic positioning of the anvil 9- coloractal anastomosis.
Resultats: the intervention was 150 minutes. no perioperative incidents. the liquid regime was authorized on the night of the intervention. the operating procedures were favorable with an exit to J2 post operative. the anapath examination of the surgical specimen confirmed the presence of sigmoidal diverticula.
Conclusion: laparoscopic sigmoidectomy with transanal extraction of the specimen for benign desease is a seductive technique with satisfactory results. it avoids a pubic incision with its parietal and aesthetic complications
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 87237
Program Number: P258
Presentation Session: iPoster Session (Non CME)
Presentation Type: Poster