Transanal Endoscopic Proctectomy

Rouanet, Philippe; Mourrégot, A.; Azar, C.; Carrère, Sébastien; Gutowski, Marian; Quénet, François; Saint-Aubert, B.; Colombo, Pierre‐Emmanuel

doi:10.1097/dcr.0b013e3182756fa0

Cited by 271 publications

(66 citation statements)

References 26 publications

(21 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Ileostomy was performed to eliminate the risk of any intestinal leak compromising healing of the urethra. This type of injury appears as an individual event in other observational series of transanal operations13 27, 28.…”

Section: Discussionmentioning

confidence: 89%

“…Obesity according to Asian standards (BMI over 25 kg/m 2 )21 22 was also seen as a contraindication, although one patient in the present series had a BMI of 27·3 kg/m 2 . Whether the complete NOTES approach to TME will be ideal in the narrow pelvis of an obese man needs further evaluation27, 28, 29, 30. In the largest series to date looking at transanal TME30, more than half of the patients had a BMI greater than 25 kg/m 2 and 12 per cent had a BMI over 30 kg/m 2 without any particular adverse influence on outcome.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Natural orifice transluminal endoscopic surgery for colorectal cancer

Thien

Thanh

et al. 2017

BJS Open

View full text Add to dashboard Cite

BackgroundNatural orifice transluminal endoscopic surgery (NOTES) has theoretical advantages over other approaches.MethodsThis was a prospective cohort study of colorectal cancers operated on by NOTES (transanally for rectal tumours, transvaginally for sigmoid tumours) between December 2013 and December 2015, with a minimum follow‐up of 1 year. Eligibility criteria included ASA fitness grade I–III, BMI below 25 kg/m2 and TNM stage T3 N0 M0. Exclusion criteria included pregnancy or distant metastasis. The anastomosis was either handsewn or performed mechanically.ResultsSixteen patients were operated on by a transanal and four by a transvaginal approach. There were ten men and ten women, with a mean(s.d.) age of 55·6(12·1) years. Mean BMI was 22·4(2·6) kg/m2. Four anterior, 11 low anterior and five intersphincteric resections were performed for 16 rectal and four low sigmoid tumours. The mean duration of surgery was 258(11) min. No conversion to laparotomy was needed, and there were no deaths. Five patients required additional ports, for intraoperative bleeding (1), suture of an intraoperative urethral injury with covering ileostomy (1) and difficulty in dissection (3). One patient had an anastomotic leak requiring transanal closure and ileostomy on day 7. Both ileostomies were closed after 2 months. The mean hospital stay was 6·4(1·8) days. All resections were R0.ConclusionIn carefully selected patients NOTES for colorectal cancer resection was feasible and effective.

show abstract

Section: Discussionmentioning

confidence: 89%

Section: Discussionmentioning

confidence: 99%

Natural orifice transluminal endoscopic surgery for colorectal cancer

Thien

Thanh

et al. 2017

BJS Open

View full text Add to dashboard Cite

show abstract

“…NOTES has therefore evolved into hybrid NOTES, with each step optimized for safe and realistic performance according to the specific indication [5]. Clinically, the POEM technique is used to treat achalasia [6,7,8], and transanal NOTES TME is utilized for colorectal resection [10,11,12,13]. …”

Section: Discussionmentioning

confidence: 99%

“…In comparison, the mean specimen length we obtained by endoscopy alone was 14.4 cm. Laparoscopic assistance during transanal TME is required for retraction, colonic mobilization, and dissection and division of the IMA [10,12,13,19]. Endoscopic instrumentation alone is considered to be of limited utility for tissue retraction.…”

Section: Discussionmentioning

confidence: 99%

“…Rather than adhering to pure NOTES or waiting for the development of more sophisticated instruments, these problems have led to the development of a hybrid NOTES technique, utilizing specific endoscopic or laparoscopic skills [5]. For example, peroral endoscopic myotomy (POEM) has become an established therapeutic option for the treatment of achalasia [5,6,7,8], and transanal total mesorectal excision (TME), a hybrid of transanal NOTES and single port laparoscopy, is a new, minimally invasive type of surgery used for colorectal resection [9,10,11,12,13]. …”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Transanal natural orifice transluminal endoscopic surgery total mesorectal excision in animal models: endoscopic inferior mesenteric artery dissection made easier by a retroperitoneal approach

et al. 2014

View full text Add to dashboard Cite

PurposeWe report the performance of natural orifice transluminal endoscopic surgery (NOTES) low anterior resection in animals using transanal total mesorectal excision (TME) with laparoscopic assistance and endoscopic inferior mesenteric artery (IMA) dissection.MethodsFour pigs weighing 45 kg each, and one dog weighing 25 kg, underwent surgery via a transanal approach. The rectum was occluded transanally using a purse-string suture, approximately 3-4 cm from the anal verge. The rectal mucosa was incised circumferentially just distal to the purse-string. A SILS or GelPOINT port was inserted transanally. Transanal TME was assisted by laparoscopy and proceeded up to the peritoneal reflection. More proximal dissection, including IMA dissection, was performed along the retroperitoneal avascular plane by endoscopy alone and facilitated by CO2 insufflation. The IMA was clipped and divided endoscopically. The mobilized rectosigmoid were exteriorized transanally and transected. A colorectal anastomosis was performed using a circular stapler with a single stapling technique.ResultsEndoscopic dissection of the IMA was successful in all five animals. The mean operation time was 125 minutes (range, 90-170 minutes). There were no intraoperative complications or hemodynamic instability. The mean length of the resected specimen was 14.4 cm (range, 12-16 cm).ConclusionA NOTES retroperitoneal approach to the IMA with CO2 insufflation and intact peritoneal covering overcame the difficulties of retraction and exposure of endoscopic dissection in animals.

show abstract

New technologies and techniques

Jones

2016

Colorectal Surgery

View full text Add to dashboard Cite

Transanal Endoscopic Proctectomy

Cited by 271 publications

References 26 publications

Natural orifice transluminal endoscopic surgery for colorectal cancer

Natural orifice transluminal endoscopic surgery for colorectal cancer

Transanal natural orifice transluminal endoscopic surgery total mesorectal excision in animal models: endoscopic inferior mesenteric artery dissection made easier by a retroperitoneal approach

New technologies and techniques

Contact Info

Product

Resources

About