Laparoscopically assisted bowel surgery for inflammatory bowel disease - The combined experiences of two academic centers

Background: Laparoscopic bowel surgery was evaluated in 44 consecutive pati ents who underwent surgery for inflammatory bowel disease (IBD). We studied feasibility, results, and final outcome. Methods: At two academic institutes, 44 laparoscopically assisted colectomi es and laparoscopic ileostomies or colostomies were attempted. All patients had histologically proven IBD and no prior surgery for IBD. Loop ileostomy (n = 4), end colostomy (n = 1), ileocecal resection (n 26) and (procto)col ectomy (n = 13) were performed. All resections were laparoscopically assist ed with extracorporal resection and anastomosis. Results: Only in two patients (ileocecal resection in both) was conversion to open surgery necessary. Two patients with laparoscopic ileocolic resecti on had intra-abdominal abscesses, which were drained percutaneously in both . One patient in the laparoscopically assisted colectomy group had a subphr enic abscess that was drained percutaneously, and one patient had a general ized candidiasis. Conclusions: Laparoscopically assisted colectomies can be performed safely in treating IBD. The laparoscopic method with use of a small vertical umbil ical or Pfannenstiel's incision seems acceptable with regard to operating t ime and overall costs, also allowing superior cosmesis to be maintained.