SINGLE PORT ACCESS LAPAROSCOPIC LOOP ILEOSTOMY; A FEASIBILITY STUDY
Diana Cheng-Robles, Zuri Murrell, Rodrigo Alban, Som Kohanzadeh, Phillip Fleshner.
Division of Colorectal Surgery, Cedars-Sinai Medical Center, Los Angeles, CA
INTRODUCTION: Permanent or temporary fecal diversion is used in the treatment of many colorectal diseases. Laparoscopic stoma creation is usually performed using two or three access ports. The aim of this study was to evaluate the surgical morbidity of a novel technique of laparoscopic stoma creation using the Triport™ single port apparatus.
METHODS AND PROCEDURES: Over a three month period ending September 2009, patients undergoing single port access laparoscopic loop ileostomy creation were prospectively evaluated. Patient age, gender, body mass index (BMI), indication for surgery, previous abdominal surgery, ASA class, duration of surgery, estimated blood loss (EBL), time to diet, length of hospital stay, and postoperative morbidity and mortality were analyzed.
RESULTS: Five patients (two male, three female) undergoing single port laparoscopic loop ileostomy formation comprised the study group. Median age was 47 years (range, 31-80 y) and median BMI was 19 (range, 17-29). All patients required surgery for complex rectosigmoid and/or perianal Crohn’s disease. Three patients (60%) had undergone previous abdominal surgery, including appendectomy (n=1), endometriosis (n=1) and ileal pouch-anal anastomosis (n=1). Median ASA class was two. Median operative time was 80 minutes (range, 66-110 min). Median time to resume a solid diet was 1 day (range, 1-11 days) and postoperative length of stay was 10 days (range, 3-12 days). There were no deaths, although two patients required readmission for partial small bowel obstruction. One patient (20%) required reoperation for stoma congestion thought due to fascial tightness.
CONCLUSION: This new application of single port technology appears to be a valid alternative to standard laparoscopic loop ileostomy creation. The technique was found to be safe for the carefully selected patient. The advantage of single port stoma creation is a virtually incisionless surgery, with the only opening used for the newly created stoma.
Session: Video Channel
Program Number: V084