Novel Application of the EK Glove Port for Single-Incision Diverting Sigmoid Loop Colostomy in Advanced Rectal Cancer

Abstract

Background and objectives: In patients with obstructing rectal cancers who require intestinal diversion before neoadjuvant therapy, minimizing diversion-related recovery and instituting early chemoradiation are critical to optimizing outcomes.

Methods: A novel, simple, safe, and inexpensive technique was developed for single-port laparoscopic diverting sigmoid loop colostomy in a low-resource environment.

Results: Ten consecutive patients with locally advanced rectal cancer underwent single-port, diverting sigmoid loop colostomy using a novel application of the EK glove port. Operative time averaged 59.5 min (range 40-75 min). There were no conversions to multiport laparoscopy or open surgery. There were no intraoperative or early postoperative surgical complications. All patients started chemoradiation therapy within 1 week of diverting colostomy. No surgical reinterventions were required.

Conclusion: Single-port laparoscopic diverting sigmoid loop colostomy utilizing an EK glove port is a novel, technically simple, safe, and cost-effective procedure, especially applicable to patients with obstructing rectal cancer who receive care in a low resource environment.

Keywords: colostomy; glove port; laparoscopy; locally advanced rectal cancer; single-port laparoscopic.

Figure 1.

EK glove port.

Figure 2.

Placement of EK glove port. A, Introducing the glove, the inner flexible ring, and the three cannulas at the same time. B, Applying the outer rigid ring. C, Creating of pneumoperitoneum. D, Introducing the laparoscope and the working instruments.

Figure 3.

Intraoperative view via the EK glove port.

Figure 4.

Appearance of the abdomen after utilization of the EK glove port for diverting colostomy.