Ryutaro Yasudome, MD, Shinichiro Mori, MD, PhD, Yoshiaki Kita, MD, PhD, Kenji Baba, MD, PhD, Masayuki Yanagi, MD, PhD, Tetsuya Ijichi, MD, Yasuto Uchikado, MD, PhD, Hiroshi Kurahara, MD, PhD, Yuko Mataki, MD, PhD, Masahiko Sakoda, MD, PhD, Akihiro Nakajo, MD, PhD, Kosei Maemura, MD, PhD, Shoji Natsugoe, MD, PhD. Department of Digestive Surgery, Breast and Thyroid Surgery, Kagoshima University School of Medicine
OBJECTIVE: Laparoscopic ileostomy commonly performed for the patients with colorectal obstruction due to cancer, peritonitis with perforation of colon or the other reason. Reduced port surgery is a novel technique that may be performed when considering minimally invasive surgery and desiring a cosmetic benefit. The aim of this study was to evaluate safety and feasibility of reduced port laparoscopic ileostomy.
METHODS: Between July 2012 and June 2016, 50 patients who underwent reduced port laparoscopic ileostomy were included 32 male and 18 female, age: 63 years old. The outcomes were evaluated in terms of operation time, intraoperative blood loss and perioperative complications.
SUGICAL PROCEDURES: The patients were placed in the supine position and the operator stood left side. An access device with the wound-protector (EZ access, HAKKO, Nagono, Japan) was inserted on the future ileostomy site in the right lower abdomen, inserting two of 5-mm trocars, maintaining pneumoperitoneum at 10 mmHg with carbon dioxide. A 5-mm trocar was inserted in the left lower abdomen. A 5-mm flexible laparoscope was inserted from access device port. After exploring abdominal cavity, ileum end was identified. Then the marking using dye was put on the ileum of 25cm proximal from the ileum end. The ileum marked by dye was grasped, and extracted through the access devise. Then a Blooke ileostomy was created.
RESULTS: Reduced port laparoscopic ileostomy was performed for 50 patients with colorectal obstruction due to cancer, ovarian cancer, peritonitis and Crohn disease etc. The mean operative time was 115 minutes, the mean blood loss was 6.9 ml. One patient received one additional port. There were no intraoperative complications. Four patients (8%) experienced postoperative complications (two of deep surgical site infection, one of pneumonia and one of renal dysfunction). There were no other intraoperative or postoperative complications.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 79948
Program Number: P583
Presentation Session: Poster (Non CME)
Presentation Type: Poster