Rapidly reversible closure of mini-laparotomy during laparoscopic colorectal surgery

• Published in: The American journal of surgery Vol. 194; no. 4; pp. 556 - 558
• Main Authors: Jamali, Faek R., M.D., F.A.C.S, Fölscher, Danie J., M.D., F.C.S. (S.A.), Bailey, Charles M.H., M.D., F.R.C.S, Leroy, Joel, M.D., F.R.C.S, Marescaux, Jacques, M.D., F.R.C.S., F.A.C.S
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 01.10.2007; Elsevier; Elsevier Limited
• Subjects: Abdomen; Biological and medical sciences; Colectomy - methods; Colonic Diseases - surgery; Colorectal surgery; General aspects; Humans; Laparoscopic surgery; Laparoscopy; Laparotomy - methods; Medical sciences; Medical treatment; Mini-laparotomy; Rectal Diseases - surgery; Reversible closure; Specimen extraction; Surgery; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Surgery of the digestive system; Time Factors; Wound healing; Wound protector; Mini-laparotomy; Laparoscopic surgery; Specimen extraction; Reversible closure; Wound protector; Medicine; Endoscopic surgery; Treatment; Closure; Extraction; Laparotomy; Wound
• ISSN: 0002-9610; 1879-1883
• DOI: 10.1016/j.amjsurg.2006.11.042

Abstract Specimen extraction has been described as the “Achilles heel” of laparoscopic colonic surgery. In most cases, this extraction is performed via a tailored, appropriately placed mini-laparotomy incision. Immediate closure of this mini-laparotomy following specimen extraction waists operative time and prevents the incision from being used for access later on in the procedure. The use of hand assist devices to allow reversible closure has been reported, not without its own drawbacks including cost and difficulty of use. We hereby describe a technique of creating a rapidly reversible closure of the mini-laparotomy incision using a simple wound protector. This technique is simple, easily reproducible, inexpensive, and effective, leading to time savings in the operating room when applied properly.