Extraperitoneal colostomy in laparoscopic abdominoperineal resection using a laparoscopic retractor

Area of Science:

• Colorectal Surgery
• Surgical Oncology
• Minimally Invasive Surgery

Background:

• Open abdominoperineal resection for lower rectal cancer can lead to parastomal hernias.
• Extraperitoneal colostomy is a known preventative measure against parastomal hernias.
• Laparoscopic approaches to extraperitoneal colostomy are challenging and not widely adopted.

Purpose of the Study:

• To describe a novel laparoscopic technique for extraperitoneal sigmoid colostomy.
• To demonstrate the ease of performing this procedure using specific instrumentation.
• To highlight the potential of this technique in preventing parastomal hernias.

Main Methods:

• The study details a laparoscopic extraperitoneal sigmoid colostomy procedure.
• The Endo Retract™ Maxi instrument is utilized to facilitate the extraperitoneal approach.
• The technique is presented as a viable laparoscopic alternative for rectal cancer surgery.

Main Results:

• The described laparoscopic extraperitoneal sigmoid colostomy technique is straightforward to perform.
• The use of the Endo Retract™ Maxi simplifies the extraperitoneal dissection.
• The technique shows promise in preventing postoperative parastomal hernias.

Conclusions:

• Laparoscopic extraperitoneal sigmoid colostomy is an accessible and effective method.
• This technique offers a solution to the challenges of laparoscopic extraperitoneal surgery.
• It provides a valuable option for reducing parastomal hernia formation after rectal cancer resection.