Anastomotic Leakage of a Colorectal Anastomosis Treated by Transanal Endoscopic Microsurgery

Abstract

We describe a possible minimally invasive technique to avoid laparotomy and/or the creation of a derivative stoma in the management of anastomotic leakage. Hospital stay is not significantly prolonged, future reïntervention for closure of stoma is avoided and sphincter function is preserved.

Transanal Endoscopic Microsurgery

“…These indications are known as ''atypical,'' as they do not involve the excision of rectal adenoma or carcinoma [33]. The atypical indications in our study is comparable to others reported that describes the indications in pelvic abscess, benign rectal stenosis, gastrointestinal stromal tumor, rectal prolapse, extraction of impacted fecaloma at the rectosigmoid junction and presacral tumor [34][35][36][37][38]. In recent years, TEM via natural orifices (natural orifice transluminal endoscopic surgery: NOTES) has been used to gain access to the peritoneal cavity and to perform intraabdominal procedures [39][40][41].…”

Transanal Endoscopic Microsurgery

“…Such efforts are best done in the lateral and posterior portions of the extraperitoneal rectum. 10,11 TEM has been used to repair an anastomotic leak 12 and to excise retrorectal tumors. 13,14 TEM has been used in a hybrid manner with other minimally invasive technology.…”

Transanal endoscopic microsurgery: long-term experience, indication expansion, and technical improvements

“…The technique presents the advantage of a perfect view of the operating field, thus enabling the extraluminal mass to be distinguished and an adapted rectotomy to be performed with good hemostatic control. It allows placement of a drain (e.g., a Foley catheter) in the cavity for drainage and irrigation [41,44].…”