Laparoscopic three-trocar sigmoidectomy with transanal extraction and new Sonicision™ cordless ultrasonic dissection device
Epublication WebSurg.com, Jun 2012;12(06). URL: http://websurg.com/doi/vd01en3732
Introduction We present the case of a 32-year-old female patient with recurrent episodes of diverticulitis. She underwent an elective sigmoidectomy using the new Sonicision™ cordless ultrasonic dissection device. Methods Our set-up consisted of a standard three-port technique with one umbilical optical 10mm port with 1x5mm and 1x12mm right iliac fossa (RIF) ports. After initial peritoneoscopy, the sigmoid mesocolon was divided close to the bowel using the new Sonicision™ cordless ultrasonic dissection device. The mesocolic window was continued distally to the rectosigmoid junction and proximally to the descending colon. The lateral attachments were then mobilized. After rectal washout, the rectum was divided and the sigmoid colon extracted transanally. A colotomy was then made above the inflamed area, the anvil of a circular stapler introduced into the colonic lumen and then advanced up to the proximal bowel (with the aid of a bowel grasper sheathed in a flexible plastic tubing). The proximal sigmoid colon was then divided with a linear stapling device, the specimen removed transanally and the rectum closed. The spike of the anvil was then delivered through the proximal colon using the fishing technique. The colorectal anastomosis was then fashioned in the usual technique with a circular stapler. A leak test was performed thereafter. Results The procedure was successfully completed. The Sonicision™ cordless ultrasonic dissection device performed similarly to other power sources but without the impedance of additional wires. It allows for ease of use and quick changing of instruments and ports without the potential of snagging the wire. Conclusion The Sonicision™ cordless ultrasonic dissection device performed excellently for laparoscopic colorectal surgery. Cordless dissectors and vessel-sealing devices will be an excellent adjunct to minimally invasive surgery of the future.