Laparoscopic-assisted colectomy and lymphadenectomy without peritoneal insufflation for sigmoid colon cancer patients.
OBJECTIVE
A new method for laparoscopic-assisted sigmoid colectomy and lymphadenectomy is presented. The purpose of this method is to avoid complications and restrictions associated with pneumoperitoneum.


METHODS
Abdominal wall is lifted up with Kirschner wires, which are placed in the middle and left lower abdomen; then a minilaparotomy, which can be created because air-tightness is not necessary, is extended at the beginning of the operation to later remove the resected specimen. Two laparoscopic instruments are inserted through the right lower abdomen. Through the minilaparotomy, the surgeon can operate with conventional instruments.


RESULTS
Operative time can be shortened, and surgical manipulations such as ligations and sutures are far easier than and cosmetic results are similar to those of laparoscopic surgery under pneumoperitoneum.


CONCLUSIONS
We believe that this technique is a safe, time-saving, and cost-beneficial technique for sigmoid colectomy, and by changing the location of the minilaparotomy, this method can also be applied to other types of gastrointestinal surgery.
Kawamura
Y J
YJ
First Department of Surgery, University of Tokyo, Japan.
Saito
H
H
Sawada
T
T
Muto
T
T
Nagai
H
H
D000009:Abdominal Muscles / Q000601:surgery; D001864:Bone Wires; D003082:Colectomy / Q000379:methods*; D012809:Colon, Sigmoid / Q000601:surgery; D004954:Esthetics; D006801:Humans; D007327:Insufflation; D020706:Laparoscopes; D010535:Laparoscopy / Q000379:methods; D007813:Laparotomy / Q000295:instrumentation / Q000379:methods; D008026:Ligation / Q000295:instrumentation; D008197:Lymph Node Excision / Q000379:methods*; D011028:Pneumoperitoneum, Artificial; D012811:Sigmoid Neoplasms / Q000601:surgery*; D013536:Suture Techniques / Q000295:instrumentation