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Single-incision assisted laparoscopic surgery (SILS) in the treatment of an intussusception induced by a solitary hamartomatous polyp: a case report and review of the literature.

Pitiakoudis M, Romanidis K, Giatromanolaki A, Courcoutsakis N, Nagorni EA, Foutzitzi S, Tsaroucha A, Zezos P, Kouklakis G - J Med Case Rep (2015)

Bottom Line: She had been admitted to the hospital because of incomplete obstructive ileus.Her pathology report revealed a benign, hamartomatous excised polyp of the Peutz-Jeghers type.The patient had a quick recovery without any post-operative complications.

View Article: PubMed Central - PubMed

Affiliation: Second Department of Surgery, Democritus University of Thrace, University Hospital of Alexandroupolis, Dragana, 68100, Alexandroupolis, Greece. mpitiak@med.duth.gr.

ABSTRACT

Introduction: In this case report, we describe the successful treatment of a small-bowel intussusception, which was caused by a 3 cm solitary hamartomatous polyp, with single-incision laparoscopic surgery. Single-incision laparoscopic surgery is a minimally invasive surgical procedure with important advantages that allows the reduction of the intussusception and the resection of the polyp. This case report contributes to the medical literature by describing the advantages of this surgical technique that warrant its consideration as a treatment of choice in similar cases.

Case presentation: We report a case of a 19-year-old Greek woman who complained about intermittent, non-specific abdominal pain in her left lateral abdomen. She had been admitted to the hospital because of incomplete obstructive ileus. Ultrasound and computed tomography were carried out, which revealed an intussusception of the small bowel. This pathogenic situation was treated by single-incision laparoscopic surgery. Her pathology report revealed a benign, hamartomatous excised polyp of the Peutz-Jeghers type. The patient had a quick recovery without any post-operative complications.

Conclusion: We recommend single-incision laparoscopic surgery for the safe excision of solitary hamartomatous polyps and the management of their complications, as it represents a potential advance in minimally invasive approaches.

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Intra-operative view of the bowel segment with the solitary polyp (arrow) after the intussusception reduction.
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Fig4: Intra-operative view of the bowel segment with the solitary polyp (arrow) after the intussusception reduction.

Mentions: After a pre-operative consultation with the patient and her family, we performed SILS. The patient was placed in the Lloyd-Davies position. Afterward, we performed a 25mm incision to the patient’s umbilicus. We used SILS™ Port 5mm-12mm (Covidien™; Medtronic, Minneapolis, MN, USA), which we also used to create a pneumoperitoneum. By using the patient’s umbilicus as a single port, first we recognized the pathogenic segment of the small bowel at a distance of 90cm from the ligament of Treitz, and continually we managed to reduce the intussusception by using articulate graspers (Figure 4). Then, we exteriorized the polyp-bearing small intestine through the umbilicus port, resected the solitary polyp and excised the invalid part of the bowel by performing a side-to-side enterostomy using Endo GIA Universal Single-Use Stapler 12mm AutoSuture (Covidien™; Medtronic).Figure 4


Single-incision assisted laparoscopic surgery (SILS) in the treatment of an intussusception induced by a solitary hamartomatous polyp: a case report and review of the literature.

Pitiakoudis M, Romanidis K, Giatromanolaki A, Courcoutsakis N, Nagorni EA, Foutzitzi S, Tsaroucha A, Zezos P, Kouklakis G - J Med Case Rep (2015)

Intra-operative view of the bowel segment with the solitary polyp (arrow) after the intussusception reduction.
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4457091&req=5

Fig4: Intra-operative view of the bowel segment with the solitary polyp (arrow) after the intussusception reduction.
Mentions: After a pre-operative consultation with the patient and her family, we performed SILS. The patient was placed in the Lloyd-Davies position. Afterward, we performed a 25mm incision to the patient’s umbilicus. We used SILS™ Port 5mm-12mm (Covidien™; Medtronic, Minneapolis, MN, USA), which we also used to create a pneumoperitoneum. By using the patient’s umbilicus as a single port, first we recognized the pathogenic segment of the small bowel at a distance of 90cm from the ligament of Treitz, and continually we managed to reduce the intussusception by using articulate graspers (Figure 4). Then, we exteriorized the polyp-bearing small intestine through the umbilicus port, resected the solitary polyp and excised the invalid part of the bowel by performing a side-to-side enterostomy using Endo GIA Universal Single-Use Stapler 12mm AutoSuture (Covidien™; Medtronic).Figure 4

Bottom Line: She had been admitted to the hospital because of incomplete obstructive ileus.Her pathology report revealed a benign, hamartomatous excised polyp of the Peutz-Jeghers type.The patient had a quick recovery without any post-operative complications.

View Article: PubMed Central - PubMed

Affiliation: Second Department of Surgery, Democritus University of Thrace, University Hospital of Alexandroupolis, Dragana, 68100, Alexandroupolis, Greece. mpitiak@med.duth.gr.

ABSTRACT

Introduction: In this case report, we describe the successful treatment of a small-bowel intussusception, which was caused by a 3 cm solitary hamartomatous polyp, with single-incision laparoscopic surgery. Single-incision laparoscopic surgery is a minimally invasive surgical procedure with important advantages that allows the reduction of the intussusception and the resection of the polyp. This case report contributes to the medical literature by describing the advantages of this surgical technique that warrant its consideration as a treatment of choice in similar cases.

Case presentation: We report a case of a 19-year-old Greek woman who complained about intermittent, non-specific abdominal pain in her left lateral abdomen. She had been admitted to the hospital because of incomplete obstructive ileus. Ultrasound and computed tomography were carried out, which revealed an intussusception of the small bowel. This pathogenic situation was treated by single-incision laparoscopic surgery. Her pathology report revealed a benign, hamartomatous excised polyp of the Peutz-Jeghers type. The patient had a quick recovery without any post-operative complications.

Conclusion: We recommend single-incision laparoscopic surgery for the safe excision of solitary hamartomatous polyps and the management of their complications, as it represents a potential advance in minimally invasive approaches.

Show MeSH
Related in: MedlinePlus