Our Summary

This research paper presents a study aimed at testing a method to avoid performing a more invasive surgical procedure, known as a laparotomy, in patients who were initially considered for a less invasive procedure called a laparoscopic colectomy.

The method involved making a small incision, also known as a “peek port,” in the patient’s abdomen to visually assess the internal conditions before deciding on the type of operation to perform. If conditions were favorable, the surgeons proceeded with a type of laparoscopic operation called hand-assisted laparoscopy (HALS). If conditions were unfavorable, they extended the incision to perform a laparotomy.

The study looked at data from 664 patients, all of whom were initially taken to the operating room with the intention of performing a laparoscopic colectomy. Of these, 79 had an initial “peek port” assessment. In 48% of these cases, the surgeons had to switch to a laparotomy, while in 52% of cases, they were able to proceed with HALS.

Among the remaining 585 patients who were immediately approached with laparoscopy, only 2% had to be switched to laparotomy. In total, among all 626 patients who underwent some form of laparoscopy, only 2% had to be converted to a laparotomy.

The study concluded that the “peek port” technique allows for prompt assessment of internal conditions and has a low rate of conversion from laparoscopy to laparotomy. It may reduce costs and complications for patients who ultimately require a laparotomy, while also permitting some patients with complex conditions to be treated minimally invasively who normally wouldn’t be considered for such a procedure.

FAQs

  1. What is the “peek port” technique and how does it help in deciding the type of operation to perform?
  2. What percentage of patients initially considered for a laparoscopic colectomy had to switch to a laparotomy?
  3. How does the “peek port” technique potentially benefit patients and affect the cost and complications of the surgery?

Doctor’s Tip

A helpful tip a doctor might tell a patient about laparoscopic colectomy is to ask about the possibility of using the “peek port” technique during the procedure. This technique can help assess internal conditions and determine the most appropriate surgical approach, potentially reducing the need for a more invasive procedure like a laparotomy. Be sure to discuss this option with your surgeon to see if it may be beneficial for your specific case.

Suitable For

Patients who are typically recommended for laparoscopic colectomy include those with conditions such as colorectal cancer, diverticulitis, inflammatory bowel disease, and other benign or malignant tumors of the colon. Patients who are relatively healthy and have a lower risk of complications from surgery are good candidates for laparoscopic colectomy. Additionally, patients who are motivated to undergo a minimally invasive procedure and have a shorter recovery time may also be recommended for laparoscopic colectomy.

Timeline

  • Before laparoscopic colectomy:
  1. Patient is evaluated by a healthcare provider and diagnosed with a condition requiring colectomy.
  2. Patient undergoes pre-operative testing and preparation.
  3. Patient discusses the procedure with their healthcare team and consents to surgery.
  4. Patient is admitted to the hospital on the day of surgery and prepared for the operation.
  5. Surgeons initially plan for a laparoscopic colectomy.
  6. In some cases, a small incision (peek port) is made to assess internal conditions before deciding on the type of operation.
  • After laparoscopic colectomy:
  1. If conditions are favorable, surgeons proceed with hand-assisted laparoscopy (HALS).
  2. If conditions are unfavorable, surgeons switch to a laparotomy.
  3. Patient undergoes the chosen surgical procedure.
  4. Patient is monitored in the hospital for post-operative care and recovery.
  5. Patient is discharged from the hospital once stable and able to manage at home.
  6. Patient follows up with their healthcare team for post-operative appointments and care.

What to Ask Your Doctor

Some questions a patient should ask their doctor about laparoscopic colectomy include:

  1. What is the difference between laparoscopic colectomy and laparotomy?
  2. Am I a candidate for a laparoscopic colectomy? Why or why not?
  3. What are the potential risks and complications associated with a laparoscopic colectomy?
  4. How long is the recovery time after a laparoscopic colectomy compared to a laparotomy?
  5. Will I require a longer hospital stay if I have a laparoscopic colectomy compared to a laparotomy?
  6. What is the success rate of laparoscopic colectomy in treating my condition?
  7. Will I require any additional procedures or treatments after a laparoscopic colectomy?
  8. How experienced are the surgeons performing the laparoscopic colectomy?
  9. What is the likelihood that my laparoscopic colectomy may need to be converted to a laparotomy during the procedure?
  10. Are there any alternative treatment options to consider besides a laparoscopic colectomy?

Reference

Authors: Jacobs C, Read TE. Journal: Surg Endosc. 2020 Sep;34(9):3944-3948. doi: 10.1007/s00464-019-07165-3. Epub 2019 Oct 4. PMID: 31586252