Laparoscopic resection with transanal specimen extraction for sigmoid diverticulitis

Abstract

Transanal specimen extraction in addition to per ano transcolonic stapler anvil insertion allows laparoscopic sigmoid resection to be performed with just three ports. Although intraperitoneal bacterial contamination occurs, this does not appear to translate into infectious morbidity.

Transanal natural orifice specimen extraction in colorectal surgery: bacteriological and oncological concerns

“…All patients were commenced on ambulatory physiotherapy and tolerated oral intake by the first post-operative day, and all met discharge criteria by the third post-operative day. There were no incidences of anastomotic leaks, fissures, or deterioration of anal continence as measured by Wexner scores immediately post-operatively and during outpatient review over a median follow-up of 9 months (range, [8][9][10][11]. The two oldest patients had preoperative Wexner scores of '1', remaining unchanged postoperatively.…”

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

“…45,46 One prospective study found no infection-related complications after transanal specimen extraction for diverticulitis despite positive polymicrobial peritoneal cultures. 47 Furthermore, anal sphincter function was not negatively impacted by transanal NOSE, 48,49 with patients reporting significant improvement in their quality of life at 6-month follow up. 50 Overall, based on these few non-randomized NOSE studies, transvaginal and transanal extraction of colorectal resection specimens appears to be safe, associated with reduced pain and shorter LOS, and offering at least the cosmetic benefit of eliminating extraction site incisions.…”

Laparoscopic resection with natural orifice specimen extraction versus conventional laparoscopy for colorectal disease: a meta-analysis

“…Recently, several studies have confirmed the safety and feasibility of laparoscopic resection with NOSE for the treatment of colorectal disease [9][10][11][12][13][14][15]. However, conflicting conclusions stating that NOSE may increase the possibility of peritoneal contamination have also been yielded [16,17]. Whether laparoscopy with NOSE is desirable to maximize the benefits of minimally invasive surgery and to minimize the risks of postoperative complications is not known.…”