Lyerly H K, Mault J R
Department of Surgery, Duke University Medical Center, Durham, North Carolina.
Ann Surg. 1994 Mar;219(3):317-22. doi: 10.1097/00000658-199403000-00013.
The technical features of laparoscopic ileostomy and colostomy are described.
A diverting ileostomy or colostomy can be performed with minimal trauma by laparoscopic techniques. This is distinct from the complex laparoscopic and laparoscopic-assisted resections of small and large bowel. To date the technical features of creating a diverting ileostomy or colostomy have not been emphasized sufficiently.
Standard laparoscopic techniques are used to create a pneumoperitoneum. After mobilization of the ileum or colon, a stoma is made on the abdominal wall. A trocar is introduced at the site where the stoma is located, thus reducing the technical problems associated with creating and maturing a stoma while the abdomen is insufflated.
This approach obviates the need for a laparotomy while creating an ileostomy or colostomy. The technical features of creating a double-barrel ostomy, an end-ostomy with a stapled distal limb, and a loop ostomy are described. The postoperative recovery is prompt with a rapid return of intestinal function and early discharge from the hospital.
Laparoscopic ileostomy and colostomy are straightforward procedures that reduce postoperative discomfort and ileus, and reduce the length of hospital stay.
描述腹腔镜回肠造口术和结肠造口术的技术特点。
通过腹腔镜技术可在创伤极小的情况下施行转流性回肠造口术或结肠造口术。这与复杂的腹腔镜及腹腔镜辅助下的小肠和大肠切除术不同。迄今为止，创建转流性回肠造口术或结肠造口术的技术特点尚未得到充分强调。
采用标准腹腔镜技术建立气腹。游离回肠或结肠后，在腹壁上造口。在造口部位插入套管针，从而减少在腹部充气时造口创建和成熟过程中出现的技术问题。
这种方法在创建回肠造口术或结肠造口术时无需开腹。描述了创建双腔造口、带吻合器闭合远端肠管的端式造口和袢式造口的技术特点。术后恢复迅速，肠道功能快速恢复且可早期出院。
腹腔镜回肠造口术和结肠造口术是简单的手术，可减轻术后不适和肠梗阻，并缩短住院时间。
