A.SIMSEK
Gulhane Military Medical Academy, Turkey
Title: Laparoscopic total colectomy with ileorectostomy for familial adenomatous polyposis
Biography
Biography: A.SIMSEK
Abstract
Familial adenomatous polyposis (FAP) is a hereditary disease which potentially predisposes affected individuals to colorectal, duodenal and thyroid cancers. Total colectomy and proctocolectomy are two options used to eliminate the risk for development of colorectal cancer in patients with FAP. Here we share our experience as a video clip with a young female FAP patient who underwent pure laparoscopic total colectomy and ileorectal anastomosis at our institute. With the patient in the modified lithotomy position, the procedure begins using five-trocar technique. Dissection of mesocolon continues clockwise starting at cecum with division of ileocolic and right colic vessels, followed by division of middle colic artery, takedown of splenic flexure, division of inferior mesenteric artery and vein. Once the entire colon is freed from the retroperitoneal and peritoneal attachments, the bowel is cut at the rectosigmoid junction using laparoscopic lineer stapler. The right-lower quadrant trocar site is widened to remove the specimen. Anvil is placed into the ileum extracorporeally. The ileorectal anastomosis is created in a side-to-end fashion laparoscopically with the circular stapler placed through the anus. Fascia closure is necessary only for 3 cm right-lower quadrant trocar site. The patient can be given oral diet POD 1. In this case, the length of procedure was four hours and the patient was discharged home on POD 6 uneventfully.
In conclusion, we believe laparoscopic approach is a good option for patients with FAP undergoing colectomy, and can enhance recovery postoperatively.