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Restorative restproctectomy as single-port surgery through the ostomy site in a three-stage procedure
Dirk Rolf Bulian1, Jürgen Knuth, Bernd Krakamp
1Department of Abdominal, Vascular and Transplant Surgery, Cologne-Merheim Medical Center, University of Witten/Herdecke, Ostmerheimer Strasse 200, 51109, Cologne, Germany. buliand@kliniken-koeln.de
Purpose:
Single-port laparoscopic surgery as an alternative to traditional laparoscopic technique is anticipated to be beneficial in the early postoperative course. We describe restorative restproctectomy as single-port surgery through the ostomy site in a three-stage procedure for refractory ulcerative colitis 12 weeks after laparoscopic subtotal colectomy.
Surgical Technique:
After release of the terminal ileostomy, creating the ileal J pouch extra-abdominally, a single-port device was placed. Through this, the rectal stump was mobilized and extracorporeally closed. The ileal pouch anal anastomosis was created using circular double-stapling technique. The single-port device was removed, and the loop ileostomy was placed at the same site.
Results:
We employed this technique in a 54 year-old patient who had suffered from ulcerative colitis. No postoperative complications were observed.
Conclusions:
Restorative restproctectomy as single-port surgery through the ostomy site is safe and feasible. No additional incision is necessary. The trauma of conventional laparoscopic access can be further reduced.
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