Laparoscopic Reduction of Sigmoidorectal Intussusception by a Modified Hutchinson’s Maneuver

Abstract Traditionally, adult intestinal intussusception is treated using Hutchinson’s maneuver, i.e., manual proximal bowel compression and reduction of intussusception. However, the lack contact in laparoscopic surgery limits application maneuver. Moreover, when lead point located distal to peritoneal refection, cannot be reduced prior resection, stoma construction (e.g., Hartmann or abdominoperineal resection) becomes necessary. Here, we report a case sigmoidorectal laparoscopically modified A 74-year-old man was diagnosed with caused by sigmoid colon cancer. Colonoscopy revealed malignant-appearing obstructing mass telescoping into rectum, at 3 cm from anal verge. During endoscopic examination, did not move. biopsy showed adenocarcinoma, leading diagnosis cancer Since patient had no symptoms ischemia, defecations were observed, elective planned. Intraoperatively, an attempt made pull out intussuscepted segment proximally, but presence fibrous adhesions irreducible. Therefore, rectum mesorectum mobilized completely up level levator ani so that lower could wrapped gauze on side The then pulled oral simultaneously, surgeon pushed end grasper, another pushing through anus fingers. Thereby, some extent, allowing for low anterior resection. resected specimen contained ulcerated moderately differentiated adenocarcinoma measuring 3.5 × 3.0 cm, combined circumferential ischemia mucosal loss necrosis over 8 length tumor. tumor stage III (T3 N1). We provide approach treating This method will useful reducing while avoiding construction.