title: Single-incision laparoscopic stoma creation: experience with 31 consecutive cases.
abstract: BACKGROUND
  Fecal diversion may be performed using various techniques. Each technique has advantages that affect patient selection. In this report, we report our experience with 31 patients who underwent single-incision laparoscopic stoma creation using only a pre-selected stoma site as the point of port access.
  
  
  METHODS
  A 2.5-cm skin incision was made at a previously marked stoma site, and two 5-mm trocars were placed into the abdomen through the stoma site. An optional third trocar was inserted at the stoma site only if the bowel needed to be mobilized or if adhesions needed to be divided. After full intra-abdominal exploration, a selected intestinal loop was brought up to the stoma site, and the ostomy was then matured using standard techniques.
  
  
  RESULTS
  Between April 2009 and March 2012, 31 patients (19 men) with a mean age of 68 years (range, 46-87 years) underwent single-incision laparoscopic stoma creation. Fecal diversion included ileostomy (n = 18) and colostomy (n = 13). There were no intraoperative complications. Two patients (6.5%) required additional port placement in the midline suprapubic area. Conversion to open laparotomy was required in two patients (6.5%) because of the presence of extensive adhesions. Postoperative complications were observed in two patients and included peristomal ileus and dehydration due to high ileostomy output.
  
  
  CONCLUSIONS
  Single-incision laparoscopic stoma creation is an effective technique that allows full intra-abdominal visualization and bowel mobilization, while reducing the need for additional skin incisions beyond that of the stoma site.
authors.affiliation: Department of Surgery, Osaka Rosai Hospital, Sakai, Japan. j-hasegawa@orh.go.jp
authors.forename: Junichi
authors.initials: J
authors.lastname: Hasegawa
authors.forename: Masaki
authors.initials: M
authors.lastname: Hirota
authors.forename: Ho Min
authors.initials: HM
authors.lastname: Kim
authors.forename: Shoki
authors.initials: S
authors.lastname: Mikata
authors.forename: Junzo
authors.initials: J
authors.lastname: Shimizu
authors.forename: Yoshihito
authors.initials: Y
authors.lastname: Soma
authors.forename: Riichiro
authors.initials: R
authors.lastname: Nezu
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D003125:Colostomy / Q000379:methods*; D061887:Conversion to Open Surgery; D005260:Female; D006801:Humans; D007081:Ileostomy / Q000379:methods*; D007415:Intestinal Obstruction / Q000209:etiology / Q000473:pathology / Q000601:surgery*; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D018579:Patient Selection
keywords: Laparoscopic surgery; single incision; stoma creation