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Single port-assisted fully laparoscopic abdominoperineal resection (APR) with immediate V-RAM flap reconstruction of the perineal defect

Abstract

Abdominoperineal resection (APR) of anorectal cancers after neoadjuvant chemoradiotherapy may incur significant perineal morbidity. While vertical rectus abdominis muscle (V-RAM) flaps can fill the pelvic resection space with health tissue, their use has previously been described predominantly in association with laparotomy. Here, we describe a means of combination laparoscopic APR with V-RAM flap reconstruction that allows structural preservation of the entire abdominal wall throughout the oncological resection and of the deep parietal layers after V-RAM donation. Furthermore, a single port access device used at the end colostomy site allows a second senior surgeon assist with an additional two working instruments for the purpose of improved pelvic tissue retraction, especially useful in obese patients.

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The authors declare no conflict of interest.

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Correspondence to Ronan A. Cahill.

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Ali, S., Moftah, M., Ajmal, N. et al. Single port-assisted fully laparoscopic abdominoperineal resection (APR) with immediate V-RAM flap reconstruction of the perineal defect. Updates Surg 64, 217–221 (2012). https://doi.org/10.1007/s13304-012-0158-z

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  • DOI: https://doi.org/10.1007/s13304-012-0158-z

Keywords

  • Anorectal cancer
  • Laparoscopic abdominoperineal resection
  • Single port laparoscopy
  • Vertical rectus abdominis muscle (V-RAM) flap