Laparoscopic-assisted proctocolectomy with prolapsing technique for familial adenomatous polyposis

Koki Otsuka, Tetsuya Itabashi, Akira Sasaki, Toshimoto Kimura, Kuniyuki Kato, Go Wakabayashi

Research output: Contribution to journalArticlepeer-review

1 Citation (Scopus)


Purpose: The role of laparoscopic total proctocolectomy (TPC) and ileal pouch-anal anastomosis (IPAA) for familial adenomatous polyposis (FAP) has been controversial, given its technical difficulty of selecting the appropriate distal transection line and achieving safe anastomosis. We herein describe our initial experience with the prolapsing technique for laparoscopic-assisted TPC and IPAA (J-pouch) in the treatment of FAP.

Methods: A consecutive series of patients with FAP undergoing laparoscopic-assisted TPC with IPAA were identified from a prospectively collected database between June 2004 and February 2012. Medical records were reviewed for patient demographics, operative outcomes, and follow-up.

Results: The surgery was successfully completed in all 6 patients without any conversion to open surgery. The median operating time was 279 minutes (range, 240 to 386 min) and the median blood loss was 17.5mL (range, 5 to 161 mL). No patient required blood transfusion. The median length of diet resumption and postoperative hospital stay were 7 days (range, 6 to 10 d) and 15 days (range, 13 to 21 d), respectively. A postoperative complication, wound infection, occurred in 1 patient. No anastomotic leakages or small bowel obstructions occurred. At a median follow-up of 59 months (range, 14.2 to 107.5 mo), no carcinoma had developed at the pouch or at the anastomotic site. Sexual function and fertility were unchanged as compared with preoperatively in 2 male patients. None of the patients experienced night-time incontinence or had to use a pad.

Conclusions: Our limited experience suggests that this prolapsing technique helps prevent problems with laparoscopic-assisted TPC and IPAA for FAP patients.

Original languageEnglish
Pages (from-to)e228-e232
JournalSurgical Laparoscopy, Endoscopy and Percutaneous Techniques
Issue number6
Publication statusPublished - 12-12-2014
Externally publishedYes

All Science Journal Classification (ASJC) codes

  • Surgery


Dive into the research topics of 'Laparoscopic-assisted proctocolectomy with prolapsing technique for familial adenomatous polyposis'. Together they form a unique fingerprint.

Cite this