GS13 SPOT MARKING FOR LAPAROSCOPIC COLECTOMIES

Abstract

Purpose: Mechanical Bowel Preparation (MBP) is often used by surgeons for patients undergoing Laparoscopic Colectomy (LC) due to the concern that small lesions normally palpable at open surgery may not be seen at the time of laparoscopic surgery. This study sought to determine whether preoperative marking of the colonic primary at the time of colonoscopy with Spot® could overcome this concern.Methodology: All patients suitable for a LC had Spot® marking performed at their colonoscopy. One millilitre of Spot® marking was injected submucosally in 3 positions around the circumference of the lumen at least 5 cm distal to the lesion. The first 100 LC performed by the surgeon for lesions were audited for the purpose of this study, and MBP was not used while all patients received preoperative immunonutrition.Results: Overall mortality was 0%. The anastomotic leak rate was 2% (1 reoperation, 1 low output fistula). Conversion rate was 23%. Spot® marking was successfully identified at laparoscopy in all 100 cases. No cases were converted as a result of failure to identify the marking, however 1 case required an extension in the final incision due to the fact the Spot® marking had been placed proximal to the lesion. Anastomoses were performed “across” the Spot® marking on 3 occasions with no untoward effect.Conclusion: Spot® marking is a safe and effective way to mark lesions in the colon in order to facilitate LC without the need for MBP.