A standardized technique for laparoscopic total colectomy in acute severe ulcerative colitis: a technical note

Area of Science:

• Surgical Innovation
• Gastroenterology
• Minimally Invasive Surgery

Background:

• Ulcerative colitis (UC) frequently requires total colectomy, with over a third of patients needing surgery despite medical advancements.
• Standardizing colectomy techniques is essential for improving surgical outcomes and reducing practice variability.

Purpose of the Study:

• To present a standardized laparoscopic total colectomy technique using a "critical view of safety" approach.
• To streamline the procedure, minimize anatomical disorientation, and facilitate trainee learning.

Main Methods:

• The technique is divided into standardized left and right/transverse colectomy phases.
• Each phase incorporates five critical views focusing on key anatomical landmarks.
• Standardized patient positioning and trocar placement are emphasized for consistency.

Main Results:

• The approach aims to reduce inter-surgeon variability and enhance procedural reproducibility.
• Potential benefits include fewer perioperative complications and shorter hospital stays.
• Alignment with ECCO guidelines for minimally invasive approaches.

Conclusions:

• A standardized "critical view of safety" laparoscopic total colectomy technique offers a reproducible and streamlined approach.
• This method can improve outcomes for ulcerative colitis patients undergoing surgery.
• Collaborative multidisciplinary care is vital for optimal patient management and decision-making.