Diagnostic laparoscopy and laparoscopic cecostomy for colonic pseudo-obstruction.
Marked cecal dilatation due to colonic psuedo-obstruction (Ogilvie's syndrome) is most often treated by colonoscopic decompression. When this fails, cecostomy is usually indicated if the bowel is not infarcted. We describe a new technique of laparoscopy-guided percutaneous cecostomy using T-fasteners to retract and anchor the cecum to the anterior abdominal wall and using a Foley catheter as a cecostomy tube. We performed this procedure successfully in a patient with colonic pseudo-obstruction who had marked cecal dilatation that could not be decompressed by colonoscopy. Laparoscopic inspection showed that the cecum was viable, and a laparoscopic cecostomy was placed. This procedure can be performed easily and safely and with much less morbidity than laparotomy and open cecostomy.
Duh
Q Y
QY
Department of Surgery, University of California, San Francisco.
Way
L W
LW
D000368:Aged; D002431:Cecostomy / Q000295:instrumentation / Q000379:methods*; D002432:Cecum / Q000000981:diagnostic imaging; D003112:Colonic Pseudo-Obstruction / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D010535:Laparoscopy; D008297:Male; D011859:Radiography