Abstract
Stoma creation through the extraperitoneal route reportedly reduces the risk of parastomal hernia and stomal prolapse after abdominoperineal resection (APR) for rectal cancer. We describe a new technique for laparoscopic extraperitoneal sigmoid colostomy following APR. After the rectus abdominis muscle is separated, Lap ProtectorTM and EZ AccessTM devices are placed. An extraperitoneal stoma tunnel is created laparoscopically as much as possible. Next, the peritoneum is separated from the inside of the abdominal cavity, and the extraperitoneal tunnel is opened. At the time of writing, we had performed laparoscopic extraperitoneal sigmoid colostomy in eight patients, without any complications or conversion to the conventional procedure. Thus, laparoscopic extraperitoneal sigmoid colostomy is a useful and safe technique for the laparoscopic creation of an extraperitoneal stoma tunnel after APR.
References
Hino H, Yamaguchi T, Kinugasa Y, Shiomi A, Kagawa H, Yamakawa Y, et al. Relationship between stoma creation route for end colostomy and parastomal hernia development after laparoscopic surgery. Surg Endosc. 2017;31:1966–73.
Hamada M, Ozaki K, Muraoka G, Kawakita N, Nishioka Y. Permanent end-sigmoid colostomy through the extraperitoneal route prevents parastomal hernia after laparoscopic abdominoperineal resection. Dis Colon Rectum. 2012;55:963–9.
Śmietański M, Szczepkowski M, Alexandre JA, Berger D, Bury K, Conze J, et al. European Hernia Society classification of parastomal hernias. Hernia. 2014;18:1–6.
Wei FX, Zhang YC, Han W, Zhang YL, Shao Y, Ni R. Transabdominal preperitoneal (TAPP) versus totally extraperitoneal (TEP) for laparoscopic hernia repair: a meta-analysis. Surg Laparosc Endosc Percutan Tech. 2015;25:375–83.
Hauters P, Cardin JL, Lepere M, Valverde A, Cossa JP, Auvray S, et al. Long-term assessment of parastomal hernia prevention by intra-peritoneal mesh reinforcement according to the modified Sugarbaker technique. Surg Endosc. 2016;30:5372–9.
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All the procedures performed in this study were carried out in accordance with the ethical standards of the institutional research committee and with the 1964 Declaration of Helsinki and its later amendments.
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Takahashi, H., Takasu, K., Nakaya, S. et al. Laparoscopic extraperitoneal sigmoid colostomy using the totally extraperitoneal hernia repair technique after abdominoperineal resection for rectal cancer. Surg Today 49, 977–980 (2019). https://doi.org/10.1007/s00595-019-01814-9
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DOI: https://doi.org/10.1007/s00595-019-01814-9