Laparoscopic sigmoid resection with transrectal specimen extraction has a good short-term outcome.
BACKGROUND
Transrectal specimen extraction in laparoscopic sigmoid resection avoids a muscle-split incision for specimen retrieval. A technique for transrectal specimen extraction is described, and the results of a pilot study concerning feasibility are presented.


METHODS
All consecutive patients undergoing laparoscopic sigmoid resection with transrectal specimen extraction were included in this observational study. A specimen retrieval pouch was used to facilitate specimen extraction. All preoperative and operative data, postoperative morbidity, and short-term outcome were gathered in a database.


RESULTS
The described technique was used to treat 21 patients. The median age of the patients was 41 years (interquartile range [IQR], 34-66 years). The median body mass index (BMI) was 23 kg/m2 (IQR, 22-26 kg/m2), and 90% of the patients were women. Of the 21 patients, 13 (62%) underwent a resection for endometriosis, 5 (24%) had resection for diverticular disease, and 3 (14%) underwent a tumor resection. The median operating time was 105 min (IQR, 90-110 min), and the median intraoperative blood loss was 10 ml (IQR, 0-20 ml). All the procedures except one (95%) were performed within 2 h. The median length of the extracted specimen was 20 cm (IQR, 13-25 cm). There was one anastomotic leak (5%), treated by emergency laparotomy and creation of a new colorectal anastomosis. None of the patients required a temporary diverting stoma, and no postoperative mortality occurred. The median hospital stay was 6 days (IQR, 5-7 days). All the patients did well during a median follow-up period of 3.6 months, and none reported any anal dysfunction.


CONCLUSIONS
Laparoscopic sigmoid resection with transrectal specimen extraction is feasible and has a good short-term outcome.
Department of Abdominal Surgery, University Hospital Gasthuisberg Leuven, Herestraat 49, 3000, Leuven, Belgium. albert.wolthuis@uzleuven.be
Albert M
AM
Wolthuis
Freddy
F
Penninckx
André
A
D'Hoore
D000328:Adult; D000368:Aged; D012809:Colon, Sigmoid / Q000601:surgery*; D043963:Diverticulosis, Colonic / Q000601:surgery*; D004715:Endometriosis / Q000601:surgery; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D012810:Sigmoid Diseases / Q000601:surgery*; D012811:Sigmoid Neoplasms / Q000601:surgery; D013536:Suture Techniques; D016896:Treatment Outcome