Système gastro-intestinal et digestif

Abstrait

Port Surgery for Colorectal Cancer Patients, Involving the Use of A Single- Incision Laparoscopic Surgery Port at the Planned Stoma Site

Masayasu Hara, Satoru Takayama, Mikinori Sato, Hiroki Takahashi, Takaya Nagasaki, Kazuyosi Shiga and Hiromitsu Takeyama

A single-incision laparoscopic surgery (SILS) port may be used to reduce the number of surgical incisions. Here, we describe our technique, equivalent in technical difficulty to conventional laparoscopy, of using a SILS port at a planned diverting-stoma site in colorectal cancer patients. This technique is indicated for patients for whom the intent is to perform tumor resection with diverting ileostomy. Because ileostomy is usually created on the right, this technique is most useful for left-sided lesions. However, an additional port in the umbilicus enables dissection of the right colon. The SILS port is placed by the open method, with additional trocars added once pneumoperitoneum is established. One trocar port is eventually used for a drain. We use this technique not only for intersphincteric resection, wherein distal rectal stump stapling is not necessary, but also in total coloproctectomy and ultralow anterior resection, which require deep pelvis stapling or right-sided colonic dissection.