Skip to main content

Laparoscopic subtotal colectomy with transrectal extraction of the colon and ileorectal anastomosis

Abstract

Background

Despite the growing acceptance of laparoscopic colon surgery, an abdominal incision is needed to remove the specimen and perform an anastomosis.

Methods

Five trocars (one 12 mm and four 5 mm) were used. The video describes the technique of performing laparoscopic subtotal colectomy, laparoscopic cholecystectomy, transrectal removal of the gallbladder and the entire colon, and intracorporeal stapled ileorectal anastomosis in a 27-year-old female with colonic inertia and biliary dyskinesia.

Results

There were no intraoperative complications. The operating time was 180 min. Blood loss was 10 cc. The patient was discharged home on postoperative day 4.

Conclusion

Laparoscopic subtotal colectomy with transrectal removal of the colon is a safe and effective procedure that can be added to the armamentarium of surgeons performing laparoscopic colon surgery. This technique may provide both an attractive way to reduce abdominal wall morbidity and a bridge to NOTES colon surgery.

This is a preview of subscription content, access via your institution.

References

  1. Winslow ER, Fleshman JW, Birnbaum EH, Brunt LM (2002) Wound complications of laparoscopic vs open colectomy. Surg Endosc 16:1420–1425

    PubMed  Article  CAS  Google Scholar 

  2. Ihedioha U, Mackay G, Leung E, Molloy RG, O’Dwyer PJ (2008) Laparoscopic colorectal resection does not reduce incisional hernia rates when compared with open colorectal resection. Surg Endosc 22:689–692

    PubMed  Article  Google Scholar 

  3. Singh R, Omiccioli A, Hegge S, McKinley C (2008) Does the extraction-site location in laparoscopic colorectal surgery have an impact on incisional hernia rates? Surg Endosc 22:596–600

    Google Scholar 

  4. Franklin ME Jr, Diaz-E JA (2000) Laparoscopic left hemicolectomy with transanal extraction of the specimen. In: Ballantyne GH (ed) Atlas of laparoscopic surgery. WB Saunders, Philadelphia, pp 386–404

    Google Scholar 

  5. Redwine DB (1996) Laparoscopically assisted transvaginal segmental resection of the rectosigmoid colon for endometriosis. Fertil Steril 65:193–197

    PubMed  CAS  Google Scholar 

  6. Nelson H, Sargent D, Wieand HS (2004) Clinical outcomes of Surgical Therapy Study Group. A comparison of laparoscopically assisted and open colectomy for colon cancer. N Engl J Med 350:2050–2059

    Article  CAS  Google Scholar 

  7. Lezoche E, Feliciotti F, Paganini AM, Guerrieri M, De Sanctis A, Minervini S, Campagnacci R (2002) Laparoscopic vs open hemicolectomy for colon cancer. Surg Endosc 16:596–602

    PubMed  Article  CAS  Google Scholar 

  8. Raftopoulos I, Courcoulas AP, Blumberg D (2006) Should completely intracorporeal anastomosis be considered in obese patients who undergo laparoscopic colectomy for benign or malignant disease of the colon? Surgery 140:675–683

    PubMed  Article  Google Scholar 

  9. Larson DW, Cima RR, Dozois EJ, Davies M, Piotrowicz K, Barnes SA, Wolff B, Pemberton J (2006) Safety, feasibility, and short-term outcomes of laparoscopic ileal-pouch-anal anastomosis: a single institutional case-matched experience. Ann Surg 243:667–672

    PubMed  Article  Google Scholar 

  10. Fabozzi M, Allieta R, Contul RB, Grivon M, Millo P, Lale-Murix E, Nardi M Jr (2010) Comparison of short- and medium-term results between laparoscopically assisted and totally laparoscopic right hemicolectomy: a case-control study. Surg Endosc 24:2085–2091

    PubMed  Article  Google Scholar 

  11. Tan WS, Chew MH, Ooi BS, Ng KH, Lim JF, Ho KS, Tang CL, Eu KW (2009) Laparoscopic versus open right hemicolectomy: a comparison of short-term outcomes. Int J Colorectal Dis 24:1333–1339

    PubMed  Article  Google Scholar 

  12. Zheng MH, Feng B, Lu AG, Li JW, Wang ML, Mao ZH, Hu YY, Dong F, Hu WG, Li DH, Zang L, Peng YF, Yu BM (2005) Laparoscopic versus open right hemicolectomy with curative intent for colon carcinoma. World J Gastroenterol 11:323–326

    PubMed  Google Scholar 

  13. Akamatsu H, Omori T, Oyama T, Tori M, Ueshima S, Nakahara M, Abe T, Nishida T (2009) Totally laparoscopic sigmoid colectomy: a simple and safe technique for intracorporeal anastomosis. Surg Endosc 23(11):2605–2609

    PubMed  Article  Google Scholar 

  14. Knol J, D’Hondt M, Dozois EJ, Vanden Boer J, Malisse P (2009) Laparoscopic-assisted sigmoidectomy with transanal specimen extraction: a bridge to NOTES? Tech Coloproctol 13(1):65–68

    PubMed  Article  CAS  Google Scholar 

Download references

Disclosure

Ziad T. Awad confirms that he has no conflicts of interest or financial ties to disclose.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Ziad T. Awad.

Electronic supplementary material

Below is the link to the electronic supplementary material.

Supplementary material 1 (MOV 299223 kb)

Rights and permissions

Reprints and Permissions

About this article

Cite this article

Awad, Z.T. Laparoscopic subtotal colectomy with transrectal extraction of the colon and ileorectal anastomosis. Surg Endosc 26, 869–871 (2012). https://doi.org/10.1007/s00464-011-1926-4

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00464-011-1926-4

Keywords

  • Laparoscopic subtotal colectomy
  • Colonic inertia
  • Transrectal
  • Intracorporeal anastomosis
  • Natural orifice surgery