Laparoscopic Welti's Maneuver: A Single-Center Experience

Area of Science:

• Colorectal Surgery
• Surgical Techniques
• Gastrointestinal Surgery

Background:

• Extended left hemicolectomy is a common procedure for various colonic diseases.
• Repositioning small bowel loops during extensive resections can be challenging.
• Welti's technique offers a specific approach for small bowel management.

Purpose of the Study:

• To evaluate the safety and efficacy of Welti's technique in extended left hemicolectomy.
• To assess the impact of Welti's technique on intestinal function recovery and hospital stay.
• To determine the mid-term incidence of bowel obstruction after this surgical approach.

Main Methods:

• Retrospective evaluation of 23 patients undergoing extended left hemicolectomy with Welti's technique.
• Assessment of operative time, resumption of bowel function (gas and stool passage), and hospital length of stay.
• Mid-term follow-up to identify episodes of acute or chronic intestinal obstruction.

Main Results:

• Median operative time was 215 minutes.
• Median resumption of gas and stool passage occurred on postoperative days 3 and 4, respectively.
• Median hospital stay was 8 days, with no observed bowel obstructions during a median 15-month follow-up.

Conclusions:

• Welti's technique is a safe and reliable method for small bowel repositioning in extended left hemicolectomy.
• The technique does not impede the resumption of intestinal function or prolong hospital stay.
• It is a valuable addition to the colorectal surgeon's armamentarium for complex cases.