Laparoscopic-assisted colectomy with the dexterity pneumo sleeve.

Abstract

The dexterity pneumo sleeve is designed to provide abdominal access for the surgeon's hand while preserving pneumoperitoneum during laparoscopy. The first experience using the dexterity pneumo sleeve in colorectal surgery is reported. Four patients with diverticulitis and one with a dolichocolon had manually assisted laparoscopic sigmoid colectomy with the dexterity pneumo sleeve. Assistance of the left hand, introduced through the dexterity device proved to be extremely helpful in identifying the plane of dissection in one patient with a large diverticular mass and in another with a colovaginal fistula. Mean operative time was 109 minutes, blood loss was 80 ml, and length of incision was 7.5 cm. Flatus reoccurred at the second postoperative day, bowel movement occurred on the third day after surgery, and patients were discharged after 4.8 days. With the dexterity pneumo sleeve, the tactile sensation is regained, which makes laparoscopic-assisted colectomy safer and faster.