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- Title
Transanal single port access to facilitate distal rectal mobilization in laparoscopic rectal sleeve resection with hand-sewn coloanal anastomosis.
- Authors
Wolthuis, A.; Cini, C.; Penninckx, F.; D'Hoore, A.
- Abstract
Background: Laparoscopic rectal sleeve resection is challenging and technically demanding. Exposure and mobilization of the most distal part of the rectum can be especially hazardous. We propose the use of a single port access device, placed in the anal canal after incision of the sleeve at the appropriate level, to facilitate dissection without sphincter damage. The case of a 51-year-old woman suffering from a recurrent supralevator abscess is presented to illustrate the technique. Methods: The procedure consisted of laparoscopic rectal pull-through with rectal sleeve resection and coloanal anastomosis. Incision of the endopelvic fascia and mobilization of the distal mesorectum was performed via the single port device under direct control. Medial-to-lateral mobilization of the colon was performed with a 3-port technique. Results: Total operating time was 122 min: 50 min for rectal mobilization, 42 min for the laparoscopic part of the procedure and 30 min for the coloanal anastomosis. The patient's recovery was uneventful, and at 1-month follow-up, she was asymptomatic. Conclusions: Laparoscopic-assisted transanal single port rectal mobilization seems to be a promising addition to the armamentarium of minimally invasive surgery.
- Subjects
LAPAROSCOPIC surgery; SURGICAL anastomosis; SURGICAL excision; COLON (Anatomy); ABSCESSES
- Publication
Techniques in Coloproctology, 2012, Vol 16, Issue 2, p161
- ISSN
1123-6337
- Publication type
Article
- DOI
10.1007/s10151-011-0795-0