PS01.117: TOTAL LAPAROSCOPIC MIDCOLON RETROSTERNAL ESOPHAGEAL BYPASS FOR CORROSIVE STRICTURE ESOPHAGUS

Abstract Description Colonic bypass for corrosive stricture of the esophagus is traditionally performed using the conventional open approach. A laparoscopic mid colon retrosternal bypass has not been reported in the literature. Total laparoscopic left colic artery based mid colon retrosternal esophageal bypass is described in this report. Method: A 25-year-old female presented with acid-induced long esophageal stricture starting at 18cm from incisors refractory to endoscopic dilatation. The laparoscopic mid colon esophageal bypass was performed using 5 abdominal ports. The essential steps are colonic mobilization and assessment of the adequacy of the mesocolic vascular arcade by clamping middle colic, right colic, and ileocolic vessels proximal to their branching, creation of the retrosternal tunnel, preparation of left colic artery based colon conduit by dividing terminal ileum proximal to ileocecal junction, neck dissection to expose cervical esophagus and delivering the colonic conduit retrosternally into the neck. Reconstruction was performed by side to side esophagocoloplasty, side to side cologastric and ileocolic anastomosis. Results: The duration of surgery was 410 minutes and blood loss was 150 mL. The patient had an uneventful postoperative course. She was started on oral semisolids on postoperative day 7 and discharged on the tenth postoperative day. At 9 months follow up the patient is euphagic to solid diet with an excellent cosmetic result. Conclusion: Total laparoscopic mid colon esophageal bypass is a feasible procedure for the management of corrosive stricture of the esophagus Disclosure All authors have declared no conflicts of interest.