Abstract
Background
Transrectal specimen extraction in laparoscopic sigmoid resection avoids a muscle-split incision for specimen retrieval. A technique for transrectal specimen extraction is described, and the results of a pilot study concerning feasibility are presented.
Methods
All consecutive patients undergoing laparoscopic sigmoid resection with transrectal specimen extraction were included in this observational study. A specimen retrieval pouch was used to facilitate specimen extraction. All preoperative and operative data, postoperative morbidity, and short-term outcome were gathered in a database.
Results
The described technique was used to treat 21 patients. The median age of the patients was 41 years (interquartile range [IQR], 34–66 years). The median body mass index (BMI) was 23 kg/m2 (IQR, 22–26 kg/m2), and 90% of the patients were women. Of the 21 patients, 13 (62%) underwent a resection for endometriosis, 5 (24%) had resection for diverticular disease, and 3 (14%) underwent a tumor resection. The median operating time was 105 min (IQR, 90–110 min), and the median intraoperative blood loss was 10 ml (IQR, 0–20 ml). All the procedures except one (95%) were performed within 2 h. The median length of the extracted specimen was 20 cm (IQR, 13–25 cm). There was one anastomotic leak (5%), treated by emergency laparotomy and creation of a new colorectal anastomosis. None of the patients required a temporary diverting stoma, and no postoperative mortality occurred. The median hospital stay was 6 days (IQR, 5–7 days). All the patients did well during a median follow-up period of 3.6 months, and none reported any anal dysfunction.
Conclusions
Laparoscopic sigmoid resection with transrectal specimen extraction is feasible and has a good short-term outcome.
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Albert M. Wolthuis, Freddy Penninckx, and André D’Hoore have no conflict of interests or financial ties to disclose.
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Wolthuis, A.M., Penninckx, F. & D’Hoore, A. Laparoscopic sigmoid resection with transrectal specimen extraction has a good short-term outcome. Surg Endosc 25, 2034–2038 (2011). https://doi.org/10.1007/s00464-010-1472-5
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DOI: https://doi.org/10.1007/s00464-010-1472-5