Laparoscopic extraperitoneal sigmoid colostomy using the totally extraperitoneal hernia repair technique after abdominoperineal resection for rectal cancer

• DOI: 10.1007/s00595-019-01814-9
• Publication Date: 2019-05-02T19:02:35Z
• Authors: Hiroki Takahashi; Korehito Takasu; Seiichi Nakaya; Takeshi Yanagita; Nanako Ando; Nozomu Nakai; Yuzo Maeda; Kazuyoshi Shiga; Takahisa Hirokawa; Mamoru Morimoto; Ryo Ogawa; Masayasu Hara; Yoichi Matsuo; Shuji Takiguchi
• Keywords: Hernia; Proctectomy; Rectal Neoplasms; Rectum; Surgical Stomas; 3. Good health; 03 medical and health sciences; Postoperative Complications; Treatment Outcome; 0302 clinical medicine; Colon, Sigmoid; Colostomy; Humans; Laparoscopy; Peritoneum; Herniorrhaphy; Retrospective Studies

Stoma creation through the extraperitoneal route reportedly reduces the risk of parastomal hernia and stomal prolapse after abdominoperineal resection (APR) for rectal cancer. We describe a new technique for laparoscopic extraperitoneal sigmoid colostomy following APR. After the rectus abdominis muscle is separated, Lap ProtectorTM and EZ AccessTM devices are placed. An extraperitoneal stoma tunnel is created laparoscopically as much as possible. Next, the peritoneum is separated from the inside of the abdominal cavity, and the extraperitoneal tunnel is opened. At the time of writing, we had performed laparoscopic extraperitoneal sigmoid colostomy in eight patients, without any complications or conversion to the conventional procedure. Thus, laparoscopic extraperitoneal sigmoid colostomy is a useful and safe technique for the laparoscopic creation of an extraperitoneal stoma tunnel after APR.