Minimal Invasive Approach for Continent Urinary and Colonic Stomas
Abstract Purpose Continent urinary reservoirs with catheterizable stomas and creation of colonic stomas for severe fecal incontinence are complex procedures usually performed simultaneously. These procedures are regarded as last-step for patients who failed conservative treatment and demand trained and interdisciplinary teams. We present a “minimal invasive appendix-Monti tube sparing strategy” of rapid learning that can be performed by transverse incision with nice end cosmetic result. Material and Methods After performing a higher Pfannestiel incision with a semicircular reflection in the middle part of the it for further low abdominal stoma creation, an ileum-based continent catheterizable reservoir (35cm) using the Macedo principle (transverse flap for outlet tube creation) was performed. The reservoir was anastomosed to the bladder. Subsequently a 4cm longitudinal para-rectal incision was done with direct access to the left colon and a transverse tube created and embedded for continence. Results The procedure took altogether 180 min and the patient had an uneventful post-operative course. Presently he is performing CIC and washing the colon once a day being continent. Conclusions The here presented “minimal invasive” strategy is a valid “easy learning” procedure for creating continent urinary and colonic stomas.