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Laparoscopically assisted ileocolectomy for Crohn's disease through a pfannenstiel incision
A K Greene1, P Michetti, M A Peppercorn
1Department of Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA.
Abstract:
Recently, laparoscopically assisted bowel resections have been shown to be less morbid than the traditional laparotomy, especially for benign conditions such as Crohn's disease. While reports describing laparoscopically assisted bowel resections use a small midline or right transverse incision, we describe a novel laparoscopically assisted approach employing a Pfannenstiel incision for Crohn's patients. We attempted the Pfannenstiel incision since it is well known to be associated with less postoperative pain, decreased ileus and hospital stay, and low rates of wound infection and incisional hernia, compared with midline or right transverse incisions. Furthermore, we found that the Pfannenstiel incision offers additional advantages that may be uniquely suited for Crohn's patients. First, the cosmetic position of the incision is particularly attractive to the young population affected by Crohn's. Second, the Pfannenstiel incision preserves fresh tissue in the midline, right, and left lower quadrants in the event that reoperation or stoma placement are required in the future owing to recurrent disease. We describe our technique in 10 consecutive patients undergoing ileocolectomy for Crohn's disease. Our patients experienced minimal morbidity and were pleased with the cosmetic results of their incisions.
Insights
This study introduces a new laparoscopic bowel resection technique for Crohn's disease using a Pfannenstiel incision. This approach offers cosmetic benefits and preserves tissue for future surgeries, showing minimal patient morbidity.
Area of Science:
- Gastroenterology
- Minimally Invasive Surgery
- Abdominal Surgery
Background:
- Laparoscopic bowel resections are less morbid than laparotomy for Crohn's disease.
- Standard laparoscopic approaches use midline or right transverse incisions.
- Pfannenstiel incisions offer advantages like reduced pain and complications.
Purpose of the Study:
- To describe a novel laparoscopic-assisted bowel resection technique for Crohn's disease using a Pfannenstiel incision.
- To evaluate the feasibility and outcomes of this approach in Crohn's patients.
Main Methods:
- A series of 10 consecutive Crohn's disease patients underwent laparoscopic-assisted ileocolectomy.
- The surgical approach utilized a Pfannenstiel incision.
- Patient outcomes including morbidity and cosmetic results were assessed.
Main Results:
- The novel technique resulted in minimal patient morbidity.
- Patients reported satisfaction with the cosmetic outcomes of the Pfannenstiel incision.
- The approach preserved viable tissue for potential future interventions.
Conclusions:
- The Pfannenstiel incision is a viable and advantageous approach for laparoscopic-assisted bowel resections in Crohn's disease patients.
- This technique offers enhanced cosmetic results and preserves tissue for future surgical needs.
- Further research may explore wider adoption of this method.