New use of an absorbable adhesion barrier (INTERCEED) for temporary diverting ileostomy in minimally invasive rectal surgery

Objectives: Sometimes, severe adhesion occurs between the rectus abdominis muscle and the ileal intestinal limbs after temporary diverting ileostomy. This can make ileostomy reversal difficult. The aim of the present study is to assess whether absorbable adhesion barrier made of oxidized regenerated cellulose (INTERCEED) could contribute to improved surgical outcomes in stoma reversal. Methods: This was a single-institutional retrospective study. A total of 36 consecutive patients who underwent ileostomy reversal by a single surgeon were retrospectively reviewed. INTERCEED was inserted between the ileal limbs and the rectus abdominis muscle at the time of ileostomy creation in 12 patients. Surgical outcomes of the ileostomy reversal were compared between patients treated with and without INTERCEED. Results:The degree of adhesion formation between the ileal limbs and the rectus abdominis muscles, operating time, and estimated blood loss were significantly reduced in patients treated with INTERCEED compared with those treated by the conventional approach. None of the patients in the INTERCEED group had postoperative complications after the initial surgery and ileostomy reversal. Conclusions: INTERCEED is suitable for insertion between the ileal limbs and the rectus abdominis muscles because of its softness and flexibility. The use of INTERCEED for diverting ileostomy contributes to reduced adhesion formation, operative time, and blood loss in patients, and further research is needed to confirm our results. (AU)

Communication and cooperation between Chinese and Japanese surgeons in minimally invasive gastrointestinal surgery in 4K era / 中华消化外科杂志

With the development of optical technology of laparoscopic equipment, the quality of surgical images has been greatly improved, which promote the rapid improvement of the quality of minimally invasive surgery for gastrointestinal tumors in Japan. In 2017, the editorial committee of Chinese Journal of Digestive Surgery organized gastroingestinal surgical experts from China and Japan to successfully hold the meeting of 'Interpretation of 4K Standardized Sino-Japanese Gastrointestinal Minimally Invasive Surgery’, hoping to exchange, promote and popularize the medical technology of China and Japan in the field of laparoscopic gastrointestinal minimally invasive surgery. Through attending the meeting, the author′s team present 4K laparoscopic radical gastrectomy with autonomic nerve preservation and other surgical procedures, introduce the recognition standard of laparoscopic technology of the Japan Society for Endoscopic Surgery, and conduct in-depth discussion with Chinese surgeons on surgical technical points and oncology quality, so as to further promote the communication and cooperation between Chinese and Japanese surgeons in minimally invasive gastrointestinal surgery.