The Easier Construction Method of Terminal Stoma by Extraperitoneal Route Using Nelaton’s Catheter

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  • To Kazuo
    Department of Digestive Surgery, Sasebo City General Hospital
  • Takeshita Hiroaki
    Department of Digestive Surgery, National Hospital Nagasaki Medical Center
  • Tominaga Tetsuro
    Department of Surgical Oncology, Nagasaki University Graduate School of Biomedical Sciences
  • Arai Junichi
    Department of Digestive Surgery, Sasebo City General Hospital
  • Nonaka Takashi
    Department of Surgical Oncology, Nagasaki University Graduate School of Biomedical Sciences
  • Kunizaki Masaki
    Department of Surgical Oncology, Nagasaki University Graduate School of Biomedical Sciences
  • Hidaka Shigekazu
    Department of Surgical Oncology, Nagasaki University Graduate School of Biomedical Sciences
  • Sawai Terumitsu
    Division of Nursing, Nagasaki University, School of Health Science, Faculty of Medicine
  • Nagayasu Takeshi
    Department of Surgical Oncology, Nagasaki University Graduate School of Biomedical Sciences
  • Ishikawa Hiroshi
    Department of Digestive Surgery, Sasebo City General Hospital

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Description

Introduction: Abdominoperineal resection is performed using laparoscopic techniques at many institutions. Few institutions construct the terminal stoma using the extraperitoneal route, mainly because of the difficulty of this approach. However, the extraperitoneal route for terminal stoma might be associated with a lower rate of complications when compared with the transperitoneal route. We construct the terminal stoma via the extraperitoneal route using Nelaton’s catheter. Materials and Surgical Technique: We call this technique the “Nelaton’s Catheter Hauling Technique”, which involves: 1) dissection of the extraperitoneal space using a intestinal spatula, 2) insertion of Nelaton’s catheter into the abdominal space via the extraperitoneal route, 3) capture of the tip of Nelaton’s catheter and pull it to the outside, 4) tying of the threads of the stump of the colon and the tip of Nelaton’s catheter, and 5) pulling up on Nelaton’s catheter to move the stump of the colon outside via the extraperitoneal route. Discussion: We believe that the use of this technique will contribute to the reduction of stoma-related complications.

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