Laparoscopic ventral pouch pexy with acellular dermal matrix (ADM)-a novel technique for the treatment of full-thickness pouch prolapse after restorative proctocolectomy and j-pouch

International Journal of Colorectal Disease
J Hardt, P Kienle

Abstract

Ileal pouch prolapse is a rare complication after j-pouch formation with an incidence of about 0.3%. However, if a pouch prolapse occurs, it can be a debilitating complication for the patient. Full-thickness pouch prolapse usually warrants surgical repair as reported by Sagar and Pemberton (Br J Surg 99(4):454-468, 2012) and Sherman et al. (Inflamm Bowel Dis 20(9):1678-1685, 2014). This report presents our first experience with laparoscopic ventral pouch pexy with acellular dermal matrix (ADM). With the patient in the French position, four trocars were positioned: a camera port at the level of the umbilicus, two 5-mm trocars in the right lower quadrant, and a third 5-mm trocar in the left lower quadrant. The j-pouch was mobilized ventrally and laterally to the level of the sphincter. A 4 × 16-cm piece of ADM (EPIFLEX®, POLYTECH Health & Aesthetics, Dieburg, Germany) was sutured to the levators on both sides and to the ventral pouch directly cranial of the sphincter. In the next step, the ADM was attached to the promontory. Subsequently, further sutures were placed to attach the pouch to the ADM. Finally, the ADM was sewn to the cranial vaginal pole. Operating time was 249 min. The postoperative course was uneventful except for ...Continue Reading

References

Apr 1, 2004·Diseases of the Colon and Rectum·Mitra EhsanRichard P Billingham
Jan 20, 2005·International Journal of Colorectal Disease·Yuji FunayamaIwao Sasaki
Apr 16, 2010·Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract·Myles R JoyceFeza H Remzi
Apr 24, 2010·Gastroenterology Research and Practice·Madhu RagupathiEric M Haas
Feb 7, 2012·The British Journal of Surgery·P M Sagar, J H Pemberton
Jul 2, 2014·Inflammatory Bowel Diseases·Jingjing ShermanAlexander J Greenstein
Sep 13, 2014·International Journal of Colorectal Disease·F A Yong, S Tsoraides
Mar 10, 2015·Diseases of the Colon and Rectum·Eric M ChangchienPeter W Bossart

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Citations

Oct 28, 2019·Surgical Endoscopy·Khan FreehaBo Shen

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