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Dual endoscopic-assisted endoluminal colostomy reversal: a feasibility study
B P Jacob1, M Gagner, T I Hung
1Division of Laparoscopic Surgery, Department of Surgery, Mount Sinai School of Medicine, 5 E 98th Street, 15th Floor, New York, NY 10029, USA.
Surgical Endoscopy
|January 31, 2004
Summary
This pilot study introduces a minimally invasive, dual endoscopic-assisted colostomy reversal technique in dogs. This new method shows feasibility for reducing recovery time and complications associated with colostomy reversal.
Area of Science:
- Surgical Innovation
- Minimally Invasive Surgery
- Gastrointestinal Surgery
Background:
- Emergent colostomies lead to increased morbidity due to subsequent closure surgeries.
- Current colostomy reversal procedures can be invasive and lengthy.
- A need exists for less invasive colostomy reversal methods.
Purpose of the Study:
- To develop and assess a minimally invasive colostomy reversal technique.
- To reduce the time interval and morbidity associated with colostomy reversals.
- To evaluate a novel approach in a canine model.
Main Methods:
- Modified laparoscopic Hartmann's procedures were performed on six dogs.
- An endoluminal colostomy reversal utilized a computer-mediated circular stapling device.
- Feasibility, operative time, complications, and recovery metrics were recorded.
Main Results:
- A novel anvil insertion technique using a large-bore needle was identified as most feasible.
- The dual endoscopic approach allowed for controlled anastomosis creation.
- Average operative time was 126 minutes, with rapid diet tolerance and bowel movement resumption.
Conclusions:
- Dual endoscopic-assisted colostomy reversal is feasible in a canine model.
- This technique allows for early reversal (1 week post-colostomy) without peritoneal entry.
- The method holds potential for reducing invasive operations and associated morbidity.