Reducing Invasiveness Using Natural Orifices And Abdominal Wall Defects

Szülőkategória: KUTATÁSI TÉMÁK
14. 12. 28
Módosítás: 01 december 2016
Készült: 28 december 2014

T. Kakucs, P. Lukovich, A Bokor

Reducing Invasiveness Using Natural Orifices And Abdominal Wall Defects

ESSR Congress, 2014 May 21-24, Budapest, Hungary


Background Laparoscopy has several advantages such as decreasing postoperative pain and the risk of incisional hernia or leaving a more aesthetic skin scar. However, in case of organ resection, the extraction of the specimen sometimes requires larger abdominal incision. In such cases, natural orifices and pathological abdominal orifices (for example inguinal hernia) are used, when possible, in order to avoid incision-related complications.

Material and Methods There were several cases in our clinical case material where there was indication for natural orifice specimen extraction. A patient with large expansive severe dysplasia of the stomach was operated laparoscopically. Intraoperatively, the lesion was detected, marked with gastroscopic monitoring and finally, after resection, the specimen was extracted through the mouth with an endobag. In several patients suffering from deeply infiltrating endometriosis that involved the rectosigma and the vagina, the specimen was routinely removed through the vagina. In other cases, where the vagina was not infiltrated, the resected bowel segment was extracted through the opened rectum. Besides natural orifices, abdominal wall defects such as inguinal hernia may be used as well, either for specimen extraction (sigmoid colon tumour after laparoscopic resection) or for single-port insertion (cholecystectomy). The operations presented above will be illustrated with videos of cases occurred at our hospital

Result .

Conclusion Natural orifices and abdominal wall defects are both suitable for specimen extraction and should be considered when planning a laparoscopic operation.