Avoiding extraction site herniation after laparoscopic right colectomy

Area of Science:

• Surgical Oncology
• Minimally Invasive Surgery
• Abdominal Surgery

Background:

• Transverse abdominal incisions are standard in enhanced recovery after surgery (ERAS) protocols.
• Minimizing abdominal wall disruption is crucial for patient recovery and long-term outcomes.
• The rectus abdominis muscle extraction site (RAMES) offers a novel approach to specimen extraction.

Purpose of the Study:

• To evaluate the safety and efficacy of the rectus abdominis muscle extraction site (RAMES) in laparoscopic right colectomy.
• To assess the incidence of incisional herniation following RAMES.
• To determine the long-term outcomes of this rectus-preserving technique.

Main Methods:

• A prospective study involving 15 patients undergoing elective laparoscopic right colectomy for malignancy.
• Utilized the rectus abdominis muscle extraction site (RAMES) for specimen retrieval.
• Assessed patients for clinical and radiological evidence of incisional herniation at 12 and 24 months post-operatively.

Main Results:

• The median wound length for the RAMES was 6 cm.
• No clinical or radiological evidence of incisional herniation was observed in any of the 15 patients at 12-month follow-up.
• No incisional herniation was detected in the 12 surviving patients at 24-month follow-up.

Conclusions:

• The rectus abdominis muscle extraction site (RAMES) is a safe and effective technique for laparoscopic right colectomy.
• This rectus-preserving approach significantly reduces the risk of early incisional herniation.
• RAMES offers potential long-term benefits by preserving abdominal wall integrity.