[Laparoscopic ileocecal resection in Crohn disease].

Overview

Patients with Crohn's ileocolitis may undergo laparoscopic ileocolectomy if an abscess or fistula is not present. At the beginning of the procedure, the mesentery and right mesocolon is dissected from the retroperitoneum without mobilization of the lateral attachments. The ileocolic vessels are identified and clipped. The resection lines are marked, the mesentery is divided with scissors, and the vessels are clipped or coagulated. If the intestine is completely mobilized, a functional end-to-end-anastomosis can be carried out. Ten laparoscopic ileocolectomies were performed since May 1993: Patients' median age 31 years (range 22-39 years), 7 women and 3 men, median operative time 115 min. (range 45-220 min.). Two intraperitoneal anastomoses and three laparoscopic-assisted resections were accomplished. No intra- or postoperative complications were noted. The first postoperative bowel movement occurred in all patients by the fifth postoperative day. The median hospital stay was 5 days (range 4-7 days). An ileocolectomy can be performed as entire laparoscopic or laparoscopic-assisted procedure dependent on intraoperative findings. The morbidity is low and patients appear to recover quickly.