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.