Two Cases of Laparoscopic Sigmoidectomy for Sigmoid Colon Cancer with Extraction through the Orifice of an External Inguinal Hernia

Abstract

Colorectal cancer and inguinal hernia occasionally present simultaneously. Two patients with sigmoid colon cancer and external inguinal hernia were treated with deliberate extraction of the specimens through the hernia orifice. The hernia orifice was protected with an abdominal cavity access device, Gel-POINT Mini®. After the lymph node dissection and mobilization, the section of the rectum distal to the tumor was transected with a linear stapling device inserted from the hernia orifice. The edge of the proximal colon was grasped and extracted through the hernia orifice. After the proximal colon was transected, the anvil head of the circular stapling device was inserted into the proximal colon. It was then returned to the abdominal cavity. The diameter of the abdominal ports could be reduced to 3-or 5-mm by inserting gauze and a linear stapling device through the hernia orifice. The inguinal hernia was repaired with mesh. The two patients were discharged 6 days after surgery without complications. Postoperative wound pain was evaluated using a numerical rating scale (range : 0 to 10), and the worst scores were 2. Both patients have had no recurrence of tumor or inguinal hernia. Key words：laparoscopic colectomy，inguinal hernia，specimen removed