title: Avoiding extraction site herniation after laparoscopic right colectomy.
abstract: Transverse abdominal wall incisions are favoured as part of enhanced recovery programmes. We explored the use of rectus-preserving extraction site incisions in laparoscopic right colectomy. The approach involved minimal anterior abdominal wall disruption with preservation of the rectus abdominis muscle: the rectus abdominis muscle extraction site (RAMES). In 15 patients, a RAMES was used electively in right colectomy for malignancy. The median wound length was 6 cms. There was no clinical or radiological evidence of incisional herniation in the 15 patients at 12-month and in the 12 survivors at 24-month follow-up. An anatomical dissection at specimen extraction site reduces early incisional herniation rates and should be of benefit in the longer term.
authors.affiliation: Department of General and Colorectal Surgery, Royal Gwent Hospital, Cardiff Road, Newport, South Wales, NP20 2UB, UK. gethin.williams@gwent.wales.nhs.uk
authors.forename: G L
authors.initials: GL
authors.lastname: Williams
authors.forename: C
authors.initials: C
authors.lastname: Beaton
authors.forename: R
authors.initials: R
authors.lastname: Codd
authors.forename: B M
authors.initials: BM
authors.lastname: Stephenson
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003082:Colectomy / Q000009:adverse effects / Q000379:methods*; D003110:Colonic Neoplasms / Q000601:surgery*; D004210:Dissection / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006555:Hernia, Ventral / Q000000981:diagnostic imaging / Q000209:etiology / Q000517:prevention & control*; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011859:Radiography; D017568:Rectus Abdominis / Q000000981:diagnostic imaging / Q000601:surgery*