LAR/Left/Right Colectomy: SSI for Laparoscopic Cases

Efforts in reducing Surgical Site Infection (SSI) rates among colorectal patients are implemented in every perioperative aspect: showering before an operation, receiving a correct mechanical and oral antibiotic preparation, utilizing the proper skin disinfectant, and others. Surgeons and the surgical technique they choose play a key role. Laparoscopic surgery is well known to reduce the SSI rate by minimizing skin incisions and allowing for a closed abdomen surgery. Nevertheless, specimen extraction still represents a potential for SSI at the mini- laparotomy site. Proper wall protection is mandatory especially when dealing with malignant disease. One viable option for further reducing the risk of SSI is to perform a  Natural Orifice Specimen Extraction (NOSE). This can be carried out during a colonic surgery (e.g. left hemicolectomy, sigmoidectomy, total colectomy or high anterior rectal resection), by performing an intra-abdominal colonic resection and utilizing for example the rectal stump (t-NOSE) as the extraction site. We here show a laparoscopic intracorporeal double purse stringed anastomosis to restore intestinal continuity. We will discuss the pros and potential cons of this technique in the fight against SSI in colorectal surgery.

PROGRAM

Clinical Background

1.  Welcome and Introduction - By Dr. Antonino Spinelli (Italy)

2.  Surgical procedure: LAP Sigma Resection with NOSE and Q&A - By Dr. Antonino Spinelli (Italy), Dr. James Glasbey (UK), Dr. Deena Harji (UK) and Dr. Borja de Lacy (Spain)

3.  Closing remarks - By Dr. Antonino Spinelli (Italy)