title: Total laparoscopic proctocolectomy with Brooke ileostomy: a novel incisionless surgical treatment for patients with ulcerative colitis.
abstract: BACKGROUND
  This report describes the clinical benefits and safety of a novel (incisionless) laparoscopic operation for chronic ulcerative colitis.
  
  
  METHODS
  The medical records for four patients with the diagnosis of chronic ulcerative colitis who underwent "incisionless" laparoscopic proctocolectomy with Brooke ileostomy were reviewed. A novel technique was used for successfully performance of four total proctocloectomies with end ileostomies that did not require abdominal incisions. The clinical outcomes measured included time to oral intake, time to ostomy output, operative time, postoperative and intraoperative complications, estimated blood loss, and length of stay.
  
  
  RESULTS
  All the patients recovered without incident intraoperatively and postoperatively. The operative times ranged from 330 to 550 min. Postoperative findings included median time to oral intake (2 days), median time to ileostomy output (2 days), and median length of stay (4 days).
  
  
  CONCLUSIONS
  This case series demonstrates that an incisionless approach to chronic ulocerative colitis for patients who desire an end ileostomy may be feasible and safe, offering patients short-term recovery and cosmetic benefits.
authors.affiliation: Division of Colon and Rectal Surgery Mayo Clinic Rochester, Mayo Clinic, Gonda 9-S, 200 Fisrt Street SW, Rochester, MN 55905, USA. Larson.david2@mayo.edu
authors.forename: D W
authors.initials: DW
authors.lastname: Larson
authors.forename: E
authors.initials: E
authors.lastname: Dozois
authors.forename: W J
authors.initials: WJ
authors.lastname: Sandborn
authors.forename: R
authors.initials: R
authors.lastname: Cima
mesh_terms: D000368:Aged; D003082:Colectomy / Q000379:methods*; D003093:Colitis, Ulcerative / Q000601:surgery*; D005260:Female; D006801:Humans; D007081:Ileostomy / Q000379:methods*; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D012007:Rectum / Q000601:surgery*