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Single-port laparoscopic fecal diversion: more than cosmetic benefits?
Erman Aytac1, Luca Stocchi, Ryan Williams
1Department of Colorectal Surgery, Digestive Disease Institute, Cleveland Clinic Foundation, Cleveland, OH.
Abstract:
Single-port laparoscopic surgery is usually performed on patients with minor comorbidities. The aim of the study was to evaluate feasibility and efficacy of single-port fecal diversion in patients who had previous abdominal operations or comorbidities. Between October 2010 and March 2012, 14 patients with a median age of 57 years were diverted. The reasons for diversion were perianal infection/abscess (n=5), anal incontinence (n=3), radiation proctitis (n=2), colovesical fistula causing sepsis (n=1), outlet obstruction of ileal S pouch (n=1), perforation during pouchoscopy (n=1), and peritoneal carcinomatosis with enterocutaneus fistula (n=1). Median estimated blood loss was 20 mL, operative time was 52 minutes, and length of hospital stay was 4 days. Two patients had ileus postoperatively. One patient had a parastomal hernia 4 months after diversion. Single-port laparoscopic fecal diversion is a safe and feasible operation for patients with significant comorbidities and a history of multiple abdominal operations.
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