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Stomal prolapse and parastomal incisional hernia treatment using laparoscopic Sugarbaker modified technique with intraperitoneal onlay mesh repair
Introduction: Prolapse stands for one of the most common complications of colostomy (>10%). Parastomal incisional hernia also represents 10 to 50% of complications. When both are present, the Sugarbaker technique represents a good indication due to mesh repair and pseudo-subperitonization, which can manage both prolapse and hernia. The laparoscopic modified Sugarbaker technique can be performed laparoscopically even in case of multiple previous laparotomies.
Clinical case: We report the case of a 71-year-old male patient presenting with parastomal incisional hernia and stomal prolapse after multiple abdominal procedures for ulcerative colitis, including rectosigmoidectomy, Hartmann procedure for anastomotic leak, left extended colectomy and stomal transposition for ischemic necrosis. An intra-abdominal proctectomy was attempted to manage the recurrence of colitis on the rectal stump. However, this attempt proved unsuccessful, and a local abdominoperineal resection was performed. Due to symptomatic hernia and prolapse, the laparoscopic Sugarbaker modified surgical technique with intraperitoneal onlay mesh (IPOM) repair is performed to manage prolapse by pseudo-subperitonization and to manage hernia using an IPOM repair. As shown in this video, this technique is safe, reproducible, and effective.
J Leroy, HA Mercoli, S Tzedakis, A D'Urso, D Mutter, J Marescaux
Surgical intervention
4 years ago
2298 views
99 likes
0 comments
10:54
Stomal prolapse and parastomal incisional hernia treatment using laparoscopic Sugarbaker modified technique with intraperitoneal onlay mesh repair
Introduction: Prolapse stands for one of the most common complications of colostomy (>10%). Parastomal incisional hernia also represents 10 to 50% of complications. When both are present, the Sugarbaker technique represents a good indication due to mesh repair and pseudo-subperitonization, which can manage both prolapse and hernia. The laparoscopic modified Sugarbaker technique can be performed laparoscopically even in case of multiple previous laparotomies.
Clinical case: We report the case of a 71-year-old male patient presenting with parastomal incisional hernia and stomal prolapse after multiple abdominal procedures for ulcerative colitis, including rectosigmoidectomy, Hartmann procedure for anastomotic leak, left extended colectomy and stomal transposition for ischemic necrosis. An intra-abdominal proctectomy was attempted to manage the recurrence of colitis on the rectal stump. However, this attempt proved unsuccessful, and a local abdominoperineal resection was performed. Due to symptomatic hernia and prolapse, the laparoscopic Sugarbaker modified surgical technique with intraperitoneal onlay mesh (IPOM) repair is performed to manage prolapse by pseudo-subperitonization and to manage hernia using an IPOM repair. As shown in this video, this technique is safe, reproducible, and effective.
Laparoscopic proctectomy with ileoanal anastomosis for inflammatory bowel disease
Total coloproctectomy with ileal pouch-anal anastomosis is the operation of choice for ulcerative colitis. The objective of this video is to demonstrate the technique used to perform a laparoscopic coloproctectomy for the treatment of inflammatory bowel disease (and particularly, ulcerative colitis) and to show the ileoanal anastomosis (with creation of an ileal J-pouch) that follows a total colectomy resection.
In this case, only sample exteriorization and ileal J-pouch formation are performed using the temporary ileostomy opening situated in the right flank.
All other steps are performed entirely laparoscopically. The dissection is carried out using the 10mm Ligasure Atlas device.
J Leroy, J Marescaux
Surgical intervention
10 years ago
1098 views
21 likes
0 comments
14:06
Laparoscopic proctectomy with ileoanal anastomosis for inflammatory bowel disease
Total coloproctectomy with ileal pouch-anal anastomosis is the operation of choice for ulcerative colitis. The objective of this video is to demonstrate the technique used to perform a laparoscopic coloproctectomy for the treatment of inflammatory bowel disease (and particularly, ulcerative colitis) and to show the ileoanal anastomosis (with creation of an ileal J-pouch) that follows a total colectomy resection.
In this case, only sample exteriorization and ileal J-pouch formation are performed using the temporary ileostomy opening situated in the right flank.
All other steps are performed entirely laparoscopically. The dissection is carried out using the 10mm Ligasure Atlas device.