Laparoscopic ileostomy and Colostomy

Abstract

ObjectiveThe technical features of laparoscopic ileostomy and colostomy are described. Summary Background DataA diverting ileostomy or colostomy can be performed with minimal trauma by laparoscopic techniques. This is distinct from the complex laparoscopic and laparoscopic-assisted resections of small and large bowel. To date, the technical features of creating a diverting ileostomy or colostomy have not been emphasized sufficiently. MethodsStandard laparoscopic techniques are used to create a pneumoperitoneum. After mobilization of the ileum or colon, a stoma is made on the abdominal wall. A trocar is introduced at the site where the stoma is located, thus reducing the technical problems associated with creating and maturing a stoma while the abdomen is insufflated. ResultsThis approach obviates the need for a laparotomy while creating an ileostomy or colostomy. The technical features of creating a double-barrel ostomy, an end-ostomy with a stapled distal limb, and a loop ostomy are described. The postoperative recovery is prompt with a rapid return of intestinal function and early discharge from the hospital. ConclusionsLaparoscopic ileostomy and colostomy are straightforward procedures that reduce postoperative discomfort and ileus, and reduce the length of hospital stay.

Laparoscopic creation of stomas

“…Despite the frequent employment of fecal diversion, few reports have described the laparoscopic technique used for such procedures. Although laparoscopic stoma creation is one of the simpler laparoscopic procedures, it has not gained much popularity [11,19]. Therefore, the aim of this study was to assess the outcome of laparoscopic stoma creation.…”

Laparoscopic loop ileostomy with a single-port stab incision technique

“…This technique would generally require 3 ports. In addition, the presence of Babcock forceps with the port cannula at the site of ostomy will be in the way when the opening in the rectus sheath is expanded and increases the risk of injury to the bowel loop held by Babcock forceps [5,10,11]. With our technique, the opening in the rectus sheath can be expanded without any interference.…”

“…Techniques for performing laparoscopic loop ileostomy have been described using two or more 10-to 12-mm ports with Hassan's technique at the umbilical site for pneumoperitoneum creation [1,2,[4][5][6][7][8]. We describe a new technique with a single-port stab incision and minimal bowel handling.…”

Minimal-invasive Chirurgie und Tumorchirurgie – Palliative laparoskopische Techniken

“…B. beim Rectumcarcinom), enteraler Umgehungsanastomosen und schließlich als Ultima ratio die Anlage eines Stoma. Enteroanastomose und Stomaanlage sind laparoskopisch durchfü hrbar [6,11,20]. Der Dü nndarm mit dem lä ngeren Mesenterium, dem geringen Durchmesser des Darmlumens und der grö ßeren Mobilitä t ist fü r laparoskopische Interventionen gut geeignet.…”