Abstract
Introduction We describe a two-port laparoscopic technique to create a colostomy in the descending
colon with separated stomas for newborns with anorectal malformations.
Material and Methods Six patients with an anorectal malformation underwent this procedure in the early-neonatal
period. The surgical technique was performed with two ports, which allows for an accurate
inspection of the abdominal contents. The first loop of the sigmoid colon is grasped
through the first port and exteriorized while the attachments to the left retroperitoneum
and direction of the loop are checked with the scope introduced in the second port.
The division of the colon is performed extracorporally, the colon irrigated of meconium,
and the distal colon moved to the second port incision. Both stomas are then fixed
to the abdominal wall.
Results The time of the procedure ranged from 50 to 90 minutes. A Mullerian duplication was
noted in one case. Oral intake was started during the first 12 to 24 hours. No complications
were seen during or after the procedure.
Conclusions This technique allows for the precise localization of the colostomy with direct visualization,
provides for the inspection of the internal genitalia, eliminates the incision between
the two stomas and its complications, allows for painless stoma bag changes immediately
after surgery, avoids twisting of the colostomy, and permits a cosmetically pleasing
incision at the colostomy closure.
Keywords
anorectal malformation - colostomy - laparoscopy
