Survival study of natural orifice translumenal endoscopic surgery for rectosigmoid resection using transanal endoscopic microsurgery with or without transgastric endoscopic assistance in a swine model

Abstract

Natural orifice translumenal endoscopic surgery (NOTES) for rectosigmoid resection using TEM with or without transgastric endoscopic assistance is feasible and associated with low morbidity in a porcine survival model. Transgastric assistance significantly prolongs the operative time but extends the length of the rectosigmoid mobilized transanally, with a nonsignificant increase in complication rates related to gastrotomy creation.

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).…”

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.…”

A natural orifice transrectal approach for oncologic resection of the rectosigmoid: an experimental study and comparison with conventional laparoscopy

“…In an effort to overcome the problems of adequate TR colon mobilization and to maintain a true incisionless approach, other investigators have used transgastric flexible endoscopy to perform sufficient colon mobilization in a porcine model [24,25]. The mean porcine colon specimen Surg Endosc (2011) 25:3357-3363 3361 length achieved reportedly was up to 15 cm with transgastric endoscopy or 10 cm without it, similar to other reports [25,26].…”