Laparoscopic intersphincteric resection and J-pouch reconstruction without laparotomy

Surg Today. 2015 May;45(5):659-62. doi: 10.1007/s00595-014-1023-0. Epub 2014 Sep 11.

Abstract

In some cases, a J-pouch is not created after laparoscopic intersphincteric resection (Lap-ISR), because this procedure usually does not involve laparotomy. This study aimed to develop a new technique for Lap-ISR and J-pouch reconstruction without laparotomy and to assess the short- and long-term outcomes of this technique. After a rectal specimen is excised using the transanal approach, the reconstructed intestine is reinserted into the intra-abdominal space. To create the J-shape, the reconstructed intestine is looped back using Allis forceps, and the septum of the J-shape is divided using a surgical stapler. We performed 20 surgeries using the new technique. Although three patients developed pelvic infections, no J-pouch-related complications were noted. Intestinal continuity could be maintained in all patients who received a diverting stoma.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Anal Canal / surgery*
  • Digestive System Surgical Procedures / methods*
  • Female
  • Humans
  • Laparoscopy / methods*
  • Laparotomy
  • Male
  • Middle Aged
  • Plastic Surgery Procedures / methods*
  • Postoperative Complications / prevention & control
  • Prospective Studies
  • Time Factors
  • Treatment Outcome