Technical considerations in children undergoing laparoscopic ileal-J-pouch anorectal anastomosis for ulcerative colitis

Abstract

A Multiport Instrument Access Port placed in the stoma site allowed the use of more instruments through a single incision. The very short ileo J-pouch low rectal anastomosis has been shown to be a safe, feasible, and effective reconstructive procedure.

Laparoscopic proctocolectomy with ileal j-pouch anal anastomosis in children

“…The incidence of pouchitis after laparoscopic surgery is reported to be 0-50% (7,9,13,14). Children who have had an ileal pouch created through the laparoscopic approach have significantly fewer occurrences of pouchitis (13).…”

“…One of the biggest advantages to creating an ileal pouch is to have reduced stool frequency because fecal continence is one of the most important components of maintaining a normal life (9). The pouch, which has stool-reserving capability, functions like the rectum, and the stool becomes more concentrated.…”

Single-Port Laparoscopic Surgery for Inflammatory Bowel Disease

“…SPLS restorative proctocolectomies in patients with ulcerative colitis were reported in 12 studies [4, 8, 13, 17–20, 26, 27, 38–40]. In most of these, the SPLS port was inserted at the site chosen for the loop ileostomy in the right iliac fossa [18], while other studies reported insertion of the SPLS port at the umbilicus, using the ileostomy site or drain site for additional 5–12 mm ports in some cases [20, 38].…”

“…The SPLS procedures include stricturoplasties, small bowel resections, ileocolic resections, sigmoid resections, subtotal colectomies with terminal ileostomies, and reconstructive proctocolectomies with ileal pouches. SPLS proctocolectomy for ulcerative colitis has been reported in minors, too [40]. However, from the available literature, it becomes apparent that most authors applied SPLS predominantly in selected patients, and therefore SPLS is currently still far from becoming a routine procedure in IBD patients.…”

Developments in pediatric colorectal pathologies

“…Ancak direkt anastomoz yapılanlarda enterit daha sık gözlendiğine dair makaleler mevcuttur (23) . Poş yapılanlarda ise poşit oranı yüksekken dışkı yapma sıklığı daha az olarak bildirilmektedir (24,25) . Laparoskopik girişimin süresi açık cerrahiye göre daha uzun saptanmakla birlikte, ameliyat sonrası daha az analjezik gereksinimi olmaktadır.…”