Single-incision Laparoscopic Proctocolectomy with Ileal J-pouch-Anal Anastomosis

Laparoscopic assisted proctocolectomy and ileoanal pouch-anal anastomosis is performed with multiple ports and an extraction incision. When compared to the traditional open procedure, the laparoscopic approach shortens the postoperative recovery and reduces adhesion formation.

To further reduce the number of incisions and abdominal wall trauma, we used a single-incision device to perform this operation. This device permits the introduction of 3 instruments through the same small abdominal opening.

This video presents a single-incision laparoscopic proctocolectomy with ileal J-pouch-anal anastomosis on a 19-year-old female with familial adenomatous polyposis syndrome. We introduced the single-incision device at the planned site for the diverting loop ileostomy.

Key steps of the procedure demonstrated in this video are:

1- Placement of single-port device via the planned ileostomy site.

2- Establishment of the pneumoperitoneum and introduction of 3 trocars.

3- Complete mobilization of the left and right colon with visualization and protection of duodenum, inferior vena cava and both ureters.

4- Complete mobilization of the base of the terminal ileum to facilitate pouch creation.

5- Complete rectal mobilization and transection at the pelvic floor.

6- Ligation of the mesenteric vessels, using a bipolar device.

7- Extraction of the specimen through the ileostomy site.

8- Ileoanal J-pouch construction.

9- Anastomosis.

10- Diverting loop ileostomy

At the end of the procedure, the only incision on the patient’s abdomen was that used for the diverting loop ileostomy. A single-incision proctocolectomy and ileoanal pouch-anal anastomosis is feasible, and can be performed safely.

Session: Podium Video Presentation

Program Number: V010

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