Laparoscopically assisted ileocolectomy for Crohn's disease through a Pfannenstiel incision

Recently, laparoscopically assisted bowel resections have been shown to be less morbid than the traditional laparotomy, especially for benign conditio ns such as Crohn's disease. While reports describing laparoscopically assis ted bowel resections use a small midline or right transverse incision, we d escribe a novel laparoscopically assisted approach employing a Pfannenstiel incision for Crohn's patients, We attempted the Pfannenstiel incision sinc e it is well known to be associated with less postoperative pain, decreased ileus and hospital stay, and low rates of wound infection and incisional h ernia, compared with midline or right transverse incisions. Furthermore, we found that the Pfannenstiel incision offers additional advantages that may be uniquely suited for Crohn's patients, First, the cosmetic position of t he incision is particularly attractive to the young population affected by Crohn's, Second, the Pfannenstiel incision preserves fresh tissue in the mi dline, right, and left lower quadrants in the event that reoperation or sto ma placement are required in the future owing to recurrent disease, We desc ribe our technique in 10 consecutive patients undergoing ileo-colectomy for Crohn's disease, Our patients experienced minimal morbidity and were pleas ed with the cosmetic results of their incisions, Am J Surg. 2000;180:238-24 0. (C) 2000 by Excerpta Medica, Inc.