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Bloemendaal ALA. Robotic Retromuscular (Recurrent) Parastomal Hernia Repair (r-Pauli-Repair) With Synthetically Reinforced Biological Mesh; Technique, Early Experience, and Short-Term Follow-Up. J Abdom Wall Surg 2023; 2:12059. [PMID: 38312416 PMCID: PMC10831679 DOI: 10.3389/jaws.2023.12059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/16/2023] [Accepted: 11/30/2023] [Indexed: 02/06/2024]
Abstract
Introduction: Parastomal hernia repair remains a challenge. We describe a robotic retromuscular non-keyhole mesh repair using a synthetically reinforced biological mesh (Ovitex) for the repair of complex and/or recurrent parastomal hernia and technical modifications we made along the way to improve our technique. Methods: All patients underwent the described retromuscular parastomal hernia repair. Data was collected in a database and a retrospective analysis was performed on direct postoperative results and early follow-up. Results: Eleven patients underwent the operation. Median follow-up was 12 months. Median LOS was 6 days. Two recurrences occurred. One patient suffered postoperative hematoma and skin necrosis, which healed completely, but did lead to a recurrence. One patient had a significant seroma, which subsided without intervention. Both recurrences were reoperated, and a local repair was performed. Conclusion: This paper is the first to describe a modified robotic Pauli repair for complex and recurrent parastomal hernia, using a synthetically reinforced biological mesh. Results are satisfying so far, especially considering the complexity of the cases.
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van Rumpt DA, Bloemendaal ALA. Recurrence of symptoms after mesh rectopexy: different reasons and different solutions. Tech Coloproctol 2023; 27:495. [PMID: 36289167 DOI: 10.1007/s10151-022-02719-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Accepted: 10/15/2022] [Indexed: 10/31/2022]
Affiliation(s)
- D A van Rumpt
- Department of Gynaecology, Reinier de Graaf Gasthuis, Delft, The Netherlands
| | - A L A Bloemendaal
- Department of Surgery, Reinier de Graaf Gasthuis, Delft, The Netherlands.
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3
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Den Hartog FPJ, Van Koten EF, Van Den Dobbelsteen JJ, Tanis PJ, Van Der Elst M, Bloemendaal ALA. Minimally Invasive Tensiometry: A New Modality for Per-Operative Measurement of Medialization and Tension During Laparoscopic Hernia Surgery. J Abdom Wall Surg 2022; 1:10850. [PMID: 38314162 PMCID: PMC10831690 DOI: 10.3389/jaws.2022.10850] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/20/2022] [Accepted: 09/13/2022] [Indexed: 02/06/2024]
Abstract
Background: Newly developed techniques for minimally invasive abdominal wall reconstruction (AWR) for complex ventral hernia are continuously evolving. In order to achieve hernia defect closure, the aponeurotic edges of the hernia defect need to be approximated. Currently, surgeons have no way to objectively measure and quantify the traction required to approximate these edges. This study presents minimally invasive tensiometry (MINT), a novel technology for measuring fascial tension, as well as initial experiences and results using it. Methods: The MINT device was designed using rapid prototyping principles. It was designed as an add-on tool for any existing laparoscopic instrument, enabling objective assessment of abdominal wall tension by the use of a manually operated linear spring. Pre-clinical measurements of medialization at 10 and 20 N of tension during AWR were performed on fresh-frozen Post-Mortem Human Specimens (PMHS). Results: Three specimens were included, and a total number of 36 measurements of medialization at three different levels of the abdominal wall were performed under structured and similar circumstances. Median total medialization with 20 Newton (N) of applied tension was 25 mm (mm) cranially, 37.5 mm at the umbilicus and 27.5 mm at the caudal level. The highest rate of medialization was seen at the umbilical level (2.25 mm/N). Conclusion: MINT is a novel non-invasive technique, which allows surgeons to intraoperatively measure fascial tension when performing AWR. The MINT device is easy to use and reproduce. The next step is to start performing clinical measurements applying MINT during AWR.
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Affiliation(s)
- F. P. J. Den Hartog
- Department of Surgery, ErasmusMC, University Medical Center, Rotterdam, Netherlands
| | - E. F. Van Koten
- Department of Biomechanical Engineering, Delft University of Technology, Delft, Netherlands
| | | | - P. J. Tanis
- Department of Surgery, ErasmusMC, University Medical Center, Rotterdam, Netherlands
- Department of Surgery, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands
| | - M. Van Der Elst
- Department of Biomechanical Engineering, Delft University of Technology, Delft, Netherlands
- Department of Surgery, Reinier de Graaf Gasthuis, Delft, Netherlands
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Bloemendaal ALA. Case Report: Intraoperative Fascial Traction in Robotic Abdominal Wall Surgery; An Early Experience. J Abdom Wall Surg 2022; 1:10356. [PMID: 38314155 PMCID: PMC10831714 DOI: 10.3389/jaws.2022.10356] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Accepted: 02/14/2022] [Indexed: 02/06/2024]
Abstract
Intraoperative fascial traction (IFT) may obviate the use of a posterior component separation/transversus abdominis release (TAR). Robotic abdominal wall surgery leads to a reduction of morbidity in TAR compared to open surgery. The combination of minimally invasive (robotic) abdominal wall surgery with IFT may lead to a further reduction of surgical morbidity.
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Buchs NC, Bloemendaal ALA, Wood CPJ, Travis S, Mortensen NJ, Guy RJ, George BD. Subtotal colectomy for ulcerative colitis: lessons learned from a tertiary centre. Colorectal Dis 2017; 19:O153-O161. [PMID: 28304125 DOI: 10.1111/codi.13658] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2016] [Accepted: 12/22/2016] [Indexed: 02/08/2023]
Abstract
AIM Subtotal colectomy (STC) is a well-established treatment for complicated and refractory ulcerative colitis (UC). A laparoscopic approach offers potentially improved outcomes. The aim of the study was to report our experience with STC for UC in a single large centre. METHOD From January 2007 to May 2015, all consecutive patients undergoing STC for UC were retrospectively analysed from a prospectively managed database. Patients with known Crohn's disease or those undergoing one-stage procedures were excluded. Demographics, perioperative outcomes and second-stage procedures were analysed. RESULTS During the study period, 151 STCs were performed for UC [100 emergency (66%) and 51 elective (34%)]. Acute severe colitis refractory to therapy was the most common indication (62%). Overall, 117 laparoscopic (78%) and 34 open STCs were performed, with a conversion rate of 14.5%. Mortality and morbidity rates were 0.7% and 38%, respectively. Whilst operative time was shorter for open STC (by 75 min; P = 0.001), there were fewer complications (32% vs 62%; P = 0.002) and a shorter hospital stay (by 6.9 days; P = 0.0002) following laparoscopic STC. Fewer complications and shorter hospital stay were also observed after elective STC. Patients undergoing laparoscopic STC were more likely to undergo a restorative second-stage procedure than those having open STC (75% vs 50%; P = 0.03). CONCLUSION Laparoscopic STC for UC is feasible and safe, even in the emergency situation. A laparoscopic approach may offer advantages in terms of lower morbidity and reduced length of stay. Elective resection may offer similar advantages and is best performed whenever possible.
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Affiliation(s)
- N C Buchs
- Department of Colorectal Surgery, Churchill Hospital, Oxford University Hospitals, Oxford, UK
| | - A L A Bloemendaal
- Department of Colorectal Surgery, Churchill Hospital, Oxford University Hospitals, Oxford, UK
| | - C P J Wood
- Department of Colorectal Surgery, Churchill Hospital, Oxford University Hospitals, Oxford, UK
| | - S Travis
- Translational Gastroenterology Unit, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - N J Mortensen
- Department of Colorectal Surgery, Churchill Hospital, Oxford University Hospitals, Oxford, UK
| | - R J Guy
- Department of Colorectal Surgery, Churchill Hospital, Oxford University Hospitals, Oxford, UK
| | - B D George
- Department of Colorectal Surgery, Churchill Hospital, Oxford University Hospitals, Oxford, UK
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6
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Bloemendaal ALA, Lovegrove R, Buchs NC, Guy RJ, George BD. Continent ileostomy (Kock pouch) formation - a video vignette. Colorectal Dis 2017; 19:85-86. [PMID: 27860124 DOI: 10.1111/codi.13562] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2016] [Accepted: 09/15/2016] [Indexed: 02/08/2023]
Affiliation(s)
- A L A Bloemendaal
- Department of Colorectal Surgery, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - R Lovegrove
- Worcestershire Acute Hospitals NHS Trust, Worcester, UK
| | - N C Buchs
- Department of Colorectal Surgery, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - R J Guy
- Department of Colorectal Surgery, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - B D George
- Department of Colorectal Surgery, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
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Buchs NC, Wynn G, Austin R, Penna M, Findlay JM, Bloemendaal ALA, Mortensen NJ, Cunningham C, Jones OM, Guy RJ, Hompes R. A two-centre experience of transanal total mesorectal excision. Colorectal Dis 2016; 18:1154-1161. [PMID: 27218423 DOI: 10.1111/codi.13394] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2015] [Accepted: 03/02/2016] [Indexed: 12/16/2022]
Abstract
AIM Transanal total mesorectal excision (TaTME) offers a promising alternative to the standard surgical abdominopelvic approach for rectal cancer. The aim of this study was to report a two-centre experience of this technique, focusing on the short-term and oncological outcome. METHOD From May 2013 to May 2015, 40 selected patients with histologically proven rectal adenocarcinoma underwent TaTME in two institutions and were prospectively entered on an online international registry. RESULTS Forty patients (80% men, mean body mass index 27.4 kg/m2 ) requiring TME underwent TaTME. Procedures included low anterior resection (n = 31), abdominoperineal excision (n = 7) and proctocolectomy (n = 2). A minimally invasive approach was attempted in all cases, with three conversions. The mean operation time was 368 min and 16 patients (40%) had a synchronous abdominal and transanal approach. There was no mortality and 16 postoperative complications occurred, of which 68.8% were minor. The median length of stay was 7.5 (3-92) days. A complete or near-complete TME specimen was delivered in 39 (97.5%) cases with a mean number of 20 lymph nodes harvested. R0 resection was achieved in 38 (95%) patients. After a median follow-up of 10.7 months, there were no local recurrences and six (15%) patients had developed distant metastases. CONCLUSION TaTME appears to be feasible, safe and reproducible, without compromising the oncological principles of rectal cancer surgery. It is an attractive option for patients for whom laparoscopy is likely to be particularly difficult. These encouraging results should encourage larger studies with assessment of long-term function and the oncological outcome.
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Affiliation(s)
- N C Buchs
- Department of Colorectal Surgery, Churchill Hospital, Oxford University Hospitals, Oxford, UK
| | - G Wynn
- ICENI Centre, Colchester Hospital University Foundation Trust, Colchester, UK
| | - R Austin
- ICENI Centre, Colchester Hospital University Foundation Trust, Colchester, UK
| | - M Penna
- Department of Colorectal Surgery, Churchill Hospital, Oxford University Hospitals, Oxford, UK
| | - J M Findlay
- Department of Colorectal Surgery, Churchill Hospital, Oxford University Hospitals, Oxford, UK.,NIHR Oxford Biomedical Research Centre, Churchill Hospital, Oxford, UK
| | - A L A Bloemendaal
- Department of Colorectal Surgery, Churchill Hospital, Oxford University Hospitals, Oxford, UK
| | - N J Mortensen
- Department of Colorectal Surgery, Churchill Hospital, Oxford University Hospitals, Oxford, UK
| | - C Cunningham
- Department of Colorectal Surgery, Churchill Hospital, Oxford University Hospitals, Oxford, UK
| | - O M Jones
- Department of Colorectal Surgery, Churchill Hospital, Oxford University Hospitals, Oxford, UK
| | - R J Guy
- Department of Colorectal Surgery, Churchill Hospital, Oxford University Hospitals, Oxford, UK
| | - R Hompes
- Department of Colorectal Surgery, Churchill Hospital, Oxford University Hospitals, Oxford, UK
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8
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Bloemendaal ALA, Kraus R, Buchs NC, Hamdy FC, Hompes R, Cogswell L, Guy RJ. Double-barrelled wet colostomy formation after pelvic exenteration for locally advanced or recurrent rectal cancer. Colorectal Dis 2016; 18:O427-O431. [PMID: 27620339 DOI: 10.1111/codi.13512] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2016] [Accepted: 07/11/2016] [Indexed: 12/11/2022]
Abstract
AIM In advanced pelvic cancer it may be necessary to perform a total pelvic exenteration. In such cases urinary tract reconstruction is usually achieved with the creation of an ileal conduit with a urinary stoma on the right side of the patient's abdomen and an end colostomy separately on the left. The potential morbidity from a second stoma may be avoided by the use of a double-barrelled wet colostomy (DBWC), as a single stoma. Another advantage is the possibility of using a vertical rectus abdominis muscle flap for perineal reconstruction. METHOD All patients undergoing formation of a DBWC were included. RESULT A DBWC was formed in 10 patients. One patient underwent formation of a double-barrelled wet ileostomy. CONCLUSIONS In this technical note we present our early experience in 11 cases and a video of DBWC formation in a male patient.
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Affiliation(s)
- A L A Bloemendaal
- Department of Colorectal Surgery, Oxford University Hospitals NHS Foundation Trust, Oxford, UK.
| | - R Kraus
- Department of Colorectal Surgery, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - N C Buchs
- Department of Colorectal Surgery, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - F C Hamdy
- Department of Urology, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
- Nuffield Department of Surgical Sciences, University of Oxford, Oxford, UK
| | - R Hompes
- Department of Colorectal Surgery, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - L Cogswell
- Nuffield Department of Surgical Sciences, University of Oxford, Oxford, UK
- Department of Plastic and Reconstructive Surgery, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - R J Guy
- Department of Colorectal Surgery, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
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9
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Bernardi MP, Bloemendaal ALA, Albert M, Whiteford M, Stevenson ARL, Hompes R. Transanal total mesorectal excision: dissection tips using 'O's and 'triangles'. Tech Coloproctol 2016; 20:775-778. [PMID: 27695959 DOI: 10.1007/s10151-016-1531-6] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2016] [Accepted: 08/31/2016] [Indexed: 01/30/2023]
Abstract
PURPOSE Transanal total mesorectal excision (taTME) requires specific technical expertise, as it is often difficult to ascertain the correct dissection plane. Consequently, one can easily enter an incorrect plane, potentially resulting in bleeding (sidewall or presacral vessels), autonomic nerve injury and urethral injury. We aim to demonstrate specific visual features, which may be encountered during surgery and can guide the surgeon to perform the dissection in the correct plane. METHOD Specific features of dissection in the correct and incorrect planes are demonstrated in the accompanying video. RESULTS The 'triangles' created using appropriate traction can aid in performing a precise dissection in the correct plane. Recognition of features described as 'O's can alert surgeons that they are entering a new fascial plane and can avoid incursion into an incorrect plane. CONCLUSION Understanding and recognizing the described features which can be encountered in taTME surgery, a safe and accurate TME dissection can be facilitated.
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Affiliation(s)
- M-P Bernardi
- Royal Brisbane and Women's Hospital, Brisbane, QLD, Australia.
| | | | - M Albert
- Florida Hospital Orlando, Winter Park, Orlando, FL, USA
| | - M Whiteford
- Providence Portland Medical Center, Portland, OR, USA
| | - A R L Stevenson
- Royal Brisbane and Women's Hospital, Brisbane, QLD, Australia
- University of Queensland, Brisbane, QLD, Australia
| | - R Hompes
- Oxford University Hospitals NHS Foundation Trust, Oxford, UK
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10
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Bloemendaal ALA, Wood CPJ, Buchs NC, Hompes R, Guy RJ. Laparoscopic component separation as part of a large incisional hernia repair - a video vignette. Colorectal Dis 2016; 18:628-9. [PMID: 27148962 DOI: 10.1111/codi.13366] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2015] [Accepted: 02/22/2016] [Indexed: 02/08/2023]
Affiliation(s)
- A L A Bloemendaal
- Department of Colorectal Surgery, Churchill Hospital, Oxford University Hospitals NHS Foundation Trust, Old Road, Headington, Oxford, OX3 7LE, UK.
| | - C P J Wood
- Department of Colorectal Surgery, Churchill Hospital, Oxford University Hospitals NHS Foundation Trust, Old Road, Headington, Oxford, OX3 7LE, UK
| | - N C Buchs
- Department of Colorectal Surgery, Churchill Hospital, Oxford University Hospitals NHS Foundation Trust, Old Road, Headington, Oxford, OX3 7LE, UK
| | - R Hompes
- Department of Colorectal Surgery, Churchill Hospital, Oxford University Hospitals NHS Foundation Trust, Old Road, Headington, Oxford, OX3 7LE, UK
| | - R J Guy
- Department of Colorectal Surgery, Churchill Hospital, Oxford University Hospitals NHS Foundation Trust, Old Road, Headington, Oxford, OX3 7LE, UK
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11
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Bloemendaal ALA, Pathiraja PN, Haldar K, Guy RJ, Hompes R. Laparoscopic pelvic side-wall resection: video vignette of the surgical anatomy. Colorectal Dis 2016; 18:628. [PMID: 27088765 DOI: 10.1111/codi.13353] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2016] [Accepted: 02/18/2016] [Indexed: 02/08/2023]
Affiliation(s)
- A L A Bloemendaal
- Department of Colorectal Surgery, Churchill Hospital, Oxford University Hospitals NHS Foundation Trust, Oxford, UK.
| | - P N Pathiraja
- Department of Gynaecological Oncology, Churchill Hospital, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - K Haldar
- Department of Gynaecological Oncology, Churchill Hospital, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - R J Guy
- Department of Colorectal Surgery, Churchill Hospital, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - R Hompes
- Department of Colorectal Surgery, Churchill Hospital, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
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Abstract
Perforated colonic cancers are not rare and leave patients at risk of developing peritoneal carcinomatosis. We present a 68-year-old male patient with a perforated transverse colonic tumour who underwent emergency extended right hemicolectomy. He made an uneventful postoperative recovery, and received adjuvant chemotherapy. Unfortunately, a routine positron emission tomography-computed tomography scan 16 months later demonstrated an fluorodeoxyglucose-avid nodule in the left scrotum associated with an irreducible left inguinal hernia that contained sigmoid colon. At laparotomy, the discovery of isolated peritoneal recurrence in the hernia sac was unexpected, given the absence of local recurrence in the region of the original transverse colon cancer perforation. The etiology therefore remains uncertain, but one may speculate that cell implantation occurred within the hernia sac at the initial emergency laparotomy.
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Affiliation(s)
- N C Buchs
- Churchill Hospital, University Hospitals of Oxford , Oxford , UK
| | | | - R J Guy
- Churchill Hospital, University Hospitals of Oxford , Oxford , UK
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13
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Bloemendaal ALA, De Schepper M, Mishra A, Hompes R, Jones OM, Lindsey I, Cunningham C. Trans-anal endoscopic microsurgery for internal rectal prolapse. Tech Coloproctol 2015; 20:129-33. [PMID: 26690927 PMCID: PMC4712247 DOI: 10.1007/s10151-015-1412-4] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2015] [Accepted: 10/30/2015] [Indexed: 12/26/2022]
Abstract
Internal rectal prolapse can lead to obstructed defecation, faecal incontinence and pain. In treatment of frail or technically difficult patients, a perineal approach is often used, such as a Delorme’s or a STARR. However, in case of very high take-off prolapse, these procedures are challenging if not unsuitable. We present trans-anal endoscopic microsurgery as surgical option for management of this uncommon type of rectal prolapse in specific cases.
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Affiliation(s)
- A L A Bloemendaal
- Department of Colorectal Surgery, Churchill Hospital, Oxford University Hospitals NHS Trust, Old Road, Headington, Oxford, OX3 7LE, UK.
| | - M De Schepper
- Department of Colorectal Surgery, Churchill Hospital, Oxford University Hospitals NHS Trust, Old Road, Headington, Oxford, OX3 7LE, UK
| | - A Mishra
- Department of Colorectal Surgery, Churchill Hospital, Oxford University Hospitals NHS Trust, Old Road, Headington, Oxford, OX3 7LE, UK
| | - R Hompes
- Department of Colorectal Surgery, Churchill Hospital, Oxford University Hospitals NHS Trust, Old Road, Headington, Oxford, OX3 7LE, UK
| | - O M Jones
- Department of Colorectal Surgery, Churchill Hospital, Oxford University Hospitals NHS Trust, Old Road, Headington, Oxford, OX3 7LE, UK
| | - I Lindsey
- Department of Colorectal Surgery, Churchill Hospital, Oxford University Hospitals NHS Trust, Old Road, Headington, Oxford, OX3 7LE, UK
| | - C Cunningham
- Department of Colorectal Surgery, Churchill Hospital, Oxford University Hospitals NHS Trust, Old Road, Headington, Oxford, OX3 7LE, UK
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14
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Bloemendaal ALA, Mishra A, Nicholson GA, Jones OM, Lindsey I, Hompes R, Cunningham C. Laparoscopic rectopexy is feasible and safe in the emergency admission setting. Colorectal Dis 2015; 17:O198-201. [PMID: 26039940 DOI: 10.1111/codi.13015] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2015] [Accepted: 04/20/2015] [Indexed: 12/21/2022]
Abstract
AIM External rectal prolapse may require emergency admission in the elderly and comorbid population. We report the safety and efficacy of laparoscopic ventral rectopexy in patients having an emergency admission with external rectal prolapse. METHOD A retrospective analysis was performed of a prospective database of all rectopexies performed from 2006. Outcome and follow-up data were assessed. RESULTS Of 812 rectopexies performed, 28 were included for analysis. The mean length of hospital stay was 13.0 days. All operations were completed successfully and without intra-operative complications. Four patients developed a postoperative complication. Two patients developed a recurrence of prolapse. CONCLUSION Laparoscopic correction of rectal prolapse following emergency admission is both feasible and safe. It can be considered for both recurring cases and cases with multiple comorbidities.
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Affiliation(s)
- A L A Bloemendaal
- Department of Colorectal and Pelvic Floor Surgery, Oxford University Hospitals NHS Trust, Oxford, UK
| | - A Mishra
- Department of Colorectal and Pelvic Floor Surgery, Oxford University Hospitals NHS Trust, Oxford, UK
| | - G A Nicholson
- Department of Colorectal and Pelvic Floor Surgery, Oxford University Hospitals NHS Trust, Oxford, UK
| | - O M Jones
- Department of Colorectal and Pelvic Floor Surgery, Oxford University Hospitals NHS Trust, Oxford, UK
| | - I Lindsey
- Department of Colorectal and Pelvic Floor Surgery, Oxford University Hospitals NHS Trust, Oxford, UK
| | - R Hompes
- Department of Colorectal and Pelvic Floor Surgery, Oxford University Hospitals NHS Trust, Oxford, UK
| | - C Cunningham
- Department of Colorectal and Pelvic Floor Surgery, Oxford University Hospitals NHS Trust, Oxford, UK
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15
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Bloemendaal ALA, Fluit AC, Jansen WTM, Vriens MR, Ferry T, Amorim JM, Pascual A, Stefani S, Papaparaskevas J, Borel Rinkes IHM, Verhoef J. Colonization with multiple Staphylococcus aureus strains among patients in European intensive care units. Infect Control Hosp Epidemiol 2009; 30:918-20. [PMID: 19653820 DOI: 10.1086/605640] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Affiliation(s)
- A L A Bloemendaal
- Department of Medical Microbiology, University Medical Center Utrecht, the Netherlands.
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16
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Bloemendaal ALA, Verwaal VJ, van Ruth S, Boot H, Zoetmulder FAN. Conventional surgery and systemic chemotherapy for peritoneal carcinomatosis of colorectal origin: a prospective study. Eur J Surg Oncol 2005; 31:1145-51. [PMID: 16084051 DOI: 10.1016/j.ejso.2005.06.002] [Citation(s) in RCA: 48] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2005] [Revised: 05/31/2005] [Accepted: 06/16/2005] [Indexed: 02/08/2023] Open
Abstract
AIMS To report the results of standard therapy for peritoneal carcinomatosis of colorectal origin, which consists of conventional surgery and systemic chemotherapy. METHOD In a prospective study 50 patients with proven peritoneal carcinomatosis of colorectal origin were treated with conventional surgery combined with 5-fluorouracil and leucovorin, or irinotecan in patients treated by 5-fluorouracil within 12 months prior to entry. Survival and progression-free survival were studied and prognostic factors were analysed. RESULTS The median survival time was 12.6 months. The median time to progression was 7.6 months. Location of primary tumour and result of conventional surgery and systemic chemotherapy were prognostic factors related to survival. CONCLUSION The survival time of patients with peritoneal carcinomatosis of colorectal origin seems to be increased in patients treated by conventional surgery and systemic chemotherapy when compared to minimal treatment.
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Affiliation(s)
- A L A Bloemendaal
- Department of Surgery, The Netherlands Cancer Institute/Antoni van Leeuwenhoek Hospital, Plesmanlaan 121, 1066 CX Amsterdam, The Netherlands
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