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Laparoscopic repair of a colonic perforation sustained during colonoscopy
M Miyahara1, S Kitano, K Shimoda
1Department of Surgery I, Oita Medical University, Japan.
Abstract:
A patient who sustained a colonic perforation during therapeutic colonoscopy was treated successfully by laparoscopic repair. Laparoscopy was performed 5 h after polypectomy. Fecal matter was not identified in the peritoneal cavity. Local peritonitis was mild. The laceration was oversewn with five sutures using the extracorporeal endoscopic knot technique. The appendix epiploica was then anchored over the lesion. The postoperative recovery was rapid and uneventful. Laparoscopic surgery may become a useful tool for the safe, effective, and minimally invasive management of iatrogenic colonic perforation.
Insights
This study shows laparoscopic repair is a safe and effective treatment for colonic perforation after colonoscopy. This minimally invasive approach led to a rapid and uneventful patient recovery.
Area of Science:
- Gastroenterology
- Minimally Invasive Surgery
- Surgical Techniques
Background:
- Iatrogenic colonic perforation is a rare but serious complication of therapeutic colonoscopy.
- Prompt and effective management is crucial to minimize patient morbidity and mortality.
Observation:
- A patient developed colonic perforation following a colonoscopic polypectomy.
- Laparoscopic repair was performed 5 hours post-procedure, with no fecal contamination or significant peritonitis.
- The laceration was repaired using endoscopic suturing, reinforced with an appendix epiploica flap.
Findings:
- Successful laparoscopic repair of iatrogenic colonic perforation.
- Extracorporeal endoscopic knot technique and flap reinforcement were utilized.
- Rapid and uneventful postoperative recovery was achieved.
Implications:
- Laparoscopic surgery offers a viable, minimally invasive option for managing iatrogenic colonic perforations.
- This technique may reduce hospital stay and improve patient outcomes compared to open surgery.
- Further research can establish laparoscopic repair as a standard of care for such injuries.