Restorative restproctectomy as single-port surgery through the ostomy site in a three-stage procedure.
OBJECTIVE
Single-port laparoscopic surgery as an alternative to traditional laparoscopic technique is anticipated to be beneficial in the early postoperative course. We describe restorative restproctectomy as single-port surgery through the ostomy site in a three-stage procedure for refractory ulcerative colitis 12 weeks after laparoscopic subtotal colectomy.


METHODS
After release of the terminal ileostomy, creating the ileal J pouch extra-abdominally, a single-port device was placed. Through this, the rectal stump was mobilized and extracorporeally closed. The ileal pouch anal anastomosis was created using circular double-stapling technique. The single-port device was removed, and the loop ileostomy was placed at the same site.


RESULTS
We employed this technique in a 54 year-old patient who had suffered from ulcerative colitis. No postoperative complications were observed.


CONCLUSIONS
Restorative restproctectomy as single-port surgery through the ostomy site is safe and feasible. No additional incision is necessary. The trauma of conventional laparoscopic access can be further reduced.
Department of Abdominal, Vascular and Transplant Surgery, Cologne-Merheim Medical Center, University of Witten/Herdecke, Ostmerheimer Strasse 200, 51109, Cologne, Germany. buliand@kliniken-koeln.de
Dirk Rolf
DR
Bulian
Jürgen
J
Knuth
Bernd
B
Krakamp
Markus Maria
MM
Heiss
D003093:Colitis, Ulcerative / Q000601:surgery*; D003125:Colostomy; D005240:Feasibility Studies; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D016737:Proctocolectomy, Restorative / Q000379:methods*