Coloport: An Instrument for Intra-operative Colonic Lavage and Intra-operative Colonoscopy
Abstract
Introduction: Obstructed left-sided colonic carcinomas have traditionally been treated by staged operations that carry several disadvantages. The principal objection to primary resection and anastomosis of unprepared bowel is the high incidence of leakage. After Miur had demonstrated that the technique of intra-operative colonic lavage and primary anastomosis was a safe procedure, this technique was later modified by Radcliffe and has now been accepted worldwide. However, the modified technique by Radcliffe has some limitations: it cannot identify the synchronous lesion that may be present somewhere proximal to the obstructing lesion during the operation. The patient needs to have a post-operative colonoscopy to rule out the lesion and risks the second operation if the lesion is found and cannot be removed by the scope. To solve this problem, the Coloport, an instrument used for intra-operative colonic lavage and intra-operative colonoscopy is invented.
Materials and Methods: Coloport is a four-way tube designed as a T-shape tube. The instrument was applied in 15 patients with lesions of the left-sided colon. Fourteen patients had cancer of the colon and rectum; another patient had colonic obstruction by foreign body. All patients were operated with intra-operative colonic lavage and intra-operative colonoscopy followed by primary resection with/ without anastomosis. None of them received pre-operative bowel preparation.
Results: Coloport was successfully applied in all cases for intra-operative colonic lavage and intra-operative colonoscopy. The colon was lavaged and clearly visualized with no synchronous lesion detected. Primary anastomosis failed in 2 patients and the patients were left with Hartmann's procedure.
Conclusions: Coloport is a new surgical device. Requiring no meticulous technique to apply, it provides intra-operative colonic lavage and intra-operative colonoscopy the much more convenient procedures.
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