Laparoscopic restorative proctocolectomy with and without previous subtotal colectomy.

Area of Science:

• Colorectal Surgery
• Minimally Invasive Surgery
• Surgical Outcomes

Background:

• Laparoscopic techniques are increasingly utilized in restorative proctocolectomy (RPC).
• Comparative outcomes of laparoscopic ileal pouch-anal anastomosis (IPAA) in virgin abdomens versus those with prior surgery are not well-defined.

Purpose of the Study:

• To compare outcomes of laparoscopic IPAA in patients undergoing RPC versus restorative proctectomy (RP).
• To identify technical tips for facilitating laparoscopic IPAA procedures.

Main Methods:

• Prospective data collection of patients undergoing laparoscopic IPAA from July 2006 to December 2007.
• Comparison of operative time and length of stay between RPC and RP groups.

Main Results:

• Thirty-six patients underwent laparoscopic IPAA (25 RPC, 11 RP).
• Postoperative morbidity was 22%.
• RP patients had significantly shorter operative times and hospital stays compared to RPC patients (P < 0.05).

Conclusions:

• Laparoscopic IPAA is a safe and feasible option for both virgin abdomens and patients with prior emergency colectomy.
• The procedure can be facilitated with specific surgical devices.