Laparoscopic loop ileostomy with a single-port stab incision technique

Abstract

Loop ileostomy is an effective means of temporary fecal diversion. It is technically easy to create and manage. Moreover, ileostomy closure does not require a formal laparotomy. With the advent of laparoscopy, many of these loop ileostomies are being performed with laparoscopic assistance. Studies have proved the beneficial effects of laparoscopically created loop ileostomy for fecal diversion. 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. We describe a modified technique, wherein pneumoperitoneum is created using a 10-mm port at the site of the future ileostomy, and a second 5-mm port is placed under vision at the umbilical site. This procedure requires minimal intervention and a reduced pneumoperitoneum time. Since the umbilical port site is 5 mm, it does not require closure, and it also reduces the chances of port-site hernia, formation, patient discomfort and scarring. Because intervention is minimally invasive, operative time is reduced, and there is less of chance postoperative ileus and adhesion formation.

Clinical Practice Guidelines for Ostomy Surgery

“…23 most laparoscopic techniques use 2 to 3 trocars, including 1 positioned through the premarked ostomy site. 24,25 Conversion to open surgery is uncommon, ranging from 0% to 16%, with more recent series reporting rates in the single digits. [19][20][21][22][26][27][28][29] When creating an ostomy laparoscopically, particular attention should be paid to avoid twisting the exteriorized bowel (for a loop ostomy) or kinking the mesentery (for an end ostomy).…”

Laparoscopic versus Open stoma creation: A retrospective analysis

“…In recent years, laparoscopic techniques have been adopted for various surgeries, including stoma creation. Since Khoo et al 7) first reported the technique of laparoscopic loop ileostomy, many less invasive techniques for stoma creation, including SILS and gasless LS creation, have been described [8][9][10][11][12][13][14] . In this study, we analyzed data from patients who underwent stoma creation and discussed the indications for the surgical approaches used.…”

“…This approach decreases blood loss and postoperative pain, reduces the duration of hospitalization, and improves the quality of life 1) . As for stoma creation, several reports about laparoscopic surgeries have been described [2][3][4][5] . The approaches used for stoma creation can be broadly classified into two groups: open stoma (OS) creation and laparoscopic stoma (LS) creation.…”

Step-wise integration of single-port laparoscopic surgery into routine colorectal surgical practice by use of a surgical glove port

“…In the last 2 years there has been a steady increase in reports on single-port laparoscopic surgery for a wide variety of indications [1][2][3][4][5][6][7]. In comparison with more conventional multiport laparoscopic approaches, this modality minimises the surgical trauma even further to facilitate improved cosmesis as well as reduced likelihood of trocar wound complications and incisional pain [8].…”