A novel single-port technique for transanal rectosigmoid resection and colorectal anastomosis on an ex vivo experimental model

Abstract

Transanal rectosigmoid resection is feasible with TEM technology. The unobstructed "empty pelvis" view is likely to enhance the quality of mesorectal dissection.

Transanal colorectal resection using natural orifice translumenal endoscopic surgery (NOTES)

“…64,[93][94][95][96][97][98][99][100][101][102][103] In the largest cadaver series to date (n = 32), our group demonstrated the feasibility of pure and hybrid transanal NOTES rectosigmoid resection, with an intact mesorectum demonstrated in all cadavers (Fig. 1).…”

Transanal endoscopic microsurgery: a review

“…135,136 Nonetheless, as TEM instruments were developed for intralumin al resection, technical difficulties, such as inadequate length of instruments to reach the midand upper abdominal structures, inability to effectively mobilize intra-abdominal organs and safely fashion anastomoses, are the barriers to clinical implementation of transanal NOTES procedures using TEM. To address these technical issues, in an experimental bovine model Bhattacharjee and colleagues 137 demonstrated a redesigned TEM instrument that is longer and more manoeuvrable. Using the modified instruments, they achieved easier dissection of mesenteric vasculature and colonic mobilization.…”

Initial experience of transanal total mesorectal excision with rigid or flexible transanal platforms in cadavers

“…Whiteford et al [4] described the use of exclusively transanal NOTES sigmoidectomy in three human cadavers, using existing transanal endoscopic microsurgery (TEM) equipment. Since then, there have been extensive cadaveric and animal studies demonstrating the feasibility and safety of taTME with or without laparoscopic assistance [5][6][7][8][9][10][11][12][13][14][15][16]. In 2010, the first clinical case of a hybrid taTME for rectal cancer was reported by Sylla et al [17]; since then, taTME has been performed in over 16 clinical series involving at least 150 patients.…”