Jakobsen Henrik Loft, Harvald Thomas B, Rosenberg Jacob
Department of Surgical Gastroenterology D, Gentofte University Hospital, Hellerup, Denmark.
Surg Laparosc Endosc Percutan Tech. 2006 Apr;16(2):104-5. doi: 10.1097/00129689-200604000-00011.
Creation of an intestinal stoma may be necessary in a wide variety of colorectal diseases of both benign and malignant character. Open and laparoscopic techniques can be used for the fecal diversion. We report a case of a patient with a diverticulitis of the sigmoid colon with abscess formation and fistulation to the abdominal wall and vagina. Owing to severe comorbidity, a permanent fecal diversion was prepared. We performed a laparoscopic no-trocar technique. Only 1 incision, at the planned stoma site, was used. The abdominal wall was elevated with gaspers, no pneumoperitoneum or trocars were used. The laparoscope and reuseable laparoscopic graspers were introduced through the stoma site to correctly identify and grasp a loop of the terminal ileum. Finally, the loop ileostomy was placed on a bar. This laparoscopic technique is a valid alternative to standard laparoscopic stoma creation. Different techniques for stoma creation are discussed.
在各种良性和恶性结直肠疾病中，可能都需要进行肠道造口术。开放式和腹腔镜技术都可用于粪便转流。我们报告了一例患有乙状结肠憩室炎并形成脓肿且与腹壁和阴道形成瘘管的患者。由于严重的合并症，准备进行永久性粪便转流。我们采用了腹腔镜无套管技术。仅在计划的造口部位做了一个切口。用抓钳抬起腹壁，未使用气腹或套管针。通过造口部位插入腹腔镜和可重复使用的腹腔镜抓钳，以正确识别并抓住一段回肠末端。最后，将回肠造口环置于杆上。这种腹腔镜技术是标准腹腔镜造口术的一种有效替代方法。文中还讨论了不同的造口术技术。
