Case Report
Copyright ©The Author(s) 2016. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Endosc. Aug 10, 2016; 8(15): 541-545
Published online Aug 10, 2016. doi: 10.4253/wjge.v8.i15.541
Standardized technique for single-incision laparoscopic-assisted stoma creation
Norikatsu Miyoshi, Shiki Fujino, Masayuki Ohue, Masayoshi Yasui, Shingo Noura, Yuma Wada, Ryuichiro Kimura, Keijiro Sugimura, Akira Tomokuni, Hirofumi Akita, Shogo Kobayashi, Hidenori Takahashi, Takeshi Omori, Yoshiyuki Fujiwara, Masahiko Yano
Norikatsu Miyoshi, Shiki Fujino, Masayuki Ohue, Masayoshi Yasui, Yuma Wada, Ryuichiro Kimura, Keijiro Sugimura, Akira Tomokuni, Hirofumi Akita, Shogo Kobayashi, Hidenori Takahashi, Takeshi Omori, Yoshiyuki Fujiwara, Masahiko Yano, Department of Surgery, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka 537-8511, Japan
Shingo Noura, Department of Surgery, Osaka Rosai Hospital, Osaka 591-8025, Japan
Author contributions: All the authors contribute to the paper.
Institutional review board statement: The institutional review board is satated by Osaka Medical Center for Cancer and Cardiovascular Diseases.
Informed consent statement: The informed consent is satated by Osaka Medical Center for Cancer and Cardiovascular Diseases.
Conflict-of-interest statement: The authors declare no conflicts of interest regarding this manuscript.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Norikatsu Miyoshi, MD, PhD, Department of Surgery, Osaka Medical Center for Cancer and Cardiovascular Diseases, 1-3-3 Nakamichi, Higashinari-ku, Osaka 537-8511, Japan. miyosi-no@mc.pref.osaka.jp
Telephone: +81-06-69721181 Fax: +81-06-69818005
Received: February 21, 2016
Peer-review started: February 23, 2016
First decision: March 25, 2016
Revised: April 11, 2016
Accepted: June 1, 2016
Article in press: June 3, 2016
Published online: August 10, 2016
Processing time: 166 Days and 20.8 Hours
Abstract

To describe the procedure, efficacy, and utility of single-incision laparoscopic-assisted stoma creation (SILStoma) for transverse colostomy. Using single-incision laparoscopic surgery, we developed a standardized technique for SILStoma. Twelve consecutive patients underwent SILStoma for transverse colostomy at Osaka Medical Center for Cancer and Cardiovascular Diseases from April 2013 to March 2016. A single, intended stoma site was created with a 2.5-3.5 cm skin incision for primary access to the intra-abdominal space, and it functioned as the main port through which multi-trocars were placed. Clinical and operative factors and postoperative outcomes were evaluated. Patient demographics, including age, gender, body mass index, and surgical indications for intestinal diversion were evaluated. SILStoma was performed in nine cases without the requirement of additional ports. In the remaining three cases, 1-2 additional 5-mm ports were required for mobilization of the transverse colon and safe dissection of abdominal adhesions. No cases required conversion to open surgery. In all cases, SILStoma was completed at the initial stoma site marked preoperatively. No intraoperative or postoperative complications greater than Grade II (the Clavien-Dindo classification) were reported in the complication survey. Surgical site infection at stoma sites was observed in four cases; however, surgical interventions were not required and all infections were cured completely. In all cases, the resumption of bowel movements was observed between postoperative days 1 and 2. SILStoma for transverse loop colostomy represents a feasible surgical procedure that allows the creation of a stoma at the preoperatively marked site without any additional large skin incisions.

Keywords: Laparoscopic surgery; Colostomy; Stoma; Postoperative complications; Cosmetic outcomes

Core tip: We described the procedure, efficacy, and utility of single-incision laparoscopic-assisted stoma creation (SILStoma) for transverse colostomy. Using single-incision laparoscopic surgery, we developed a standardized technique for SILStoma. Twelve consecutive patients underwent SILStoma for transverse colostomy. In all cases, SILStoma was completed at the initial stoma site marked preoperatively. No complications were reported in the complication survey. SILStoma for transverse loop colostomy represents a feasible surgical procedure allowing stoma creation at ideal stoma sites marked preoperatively. Reductions in the number of port sites and the avoidance of additional skin incisions may result in improved cosmetic outcomes and patient quality of life.