Department of Digestive Surgery, Breast and Thyroid Surgery, Graduate School of Medicine, Kagoshima University, Kagoshima, Japan.
Asian J Endosc Surg. 2020 Oct;13(4):618-621. doi: 10.1111/ases.12790. Epub 2020 Feb 17.
In closure of a stoma, the small working space and adhesions hinder a precise surgical procedure, compared with conventional approaches to digestive surgery. The aim of this prospective study was to introduce a new technique of laparoscopic stoma closure (LASC).
After starting with three trocars, it is a priority to dissect around the arising ileum; a linear stapler is precisely inserted in both orifices of the loop stoma and applied two times, extracorporeally. Ultimately, both the oral and anal sides of the loop ileum are cut and closed using a linear cutter stapler in a delta-shaped manner just under the abdominal wall, intracorporeally. Eventually, the arising stoma is removed using an intra-abdominal and cutaneous approach.
LASC for patients with a temporary loop ileostomy is safe and feasible. More data and experience will be required to verify the benefits of this new technique.
与传统的消化道手术方法相比,在进行造口关闭手术时,由于操作空间小和粘连,会给精确的手术过程带来困难。本前瞻性研究旨在介绍一种新的腹腔镜造口关闭技术(LASC)。
首先通过三个套管进行操作,然后优先解剖升结肠;将线性吻合器精确插入肠环造口的两个孔中,并在体外应用两次。最终,在体内,通过线性切割吻合器以 delta 形状从腹部壁下方切除并关闭肠环的口腔侧和肛门侧。最终,通过腹腔内和皮内途径取出出现的造口。
对于有临时肠造口术的患者,LASC 是安全且可行的。需要更多的数据和经验来验证这项新技术的益处。