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Clinical Application of Single-Surgeon, Three-Port, Laparoscopic Resection for Colorectal Cancer with Natural Orifice Specimen Extraction
Published on: March 24, 2023
Minilaparoscopy-assisted natural orifice surgery.
Daniel A Tsin1, Liliana T Colombero, Johann Lambeck
1The Mount Sinai Hospital of Queens, Department of Minimally Invasive Surgery, Long Island City, New York 11102, USA. LaserGYN@aol.com
Summary
Minilaparoscopy-assisted natural orifice surgery (MANOS) offers a solution for scarless surgery, proving feasible in 100 cases with minimal complications. This technique could accelerate the adoption of natural orifice surgery.
Area of Science:
- Minimally invasive surgical techniques
- Natural orifice transluminal endoscopic surgery (NOTES)
- Surgical innovation
Background:
- Advancements in surgical technology enable smaller instruments for abdominal and pelvic surgeries.
- The ultimate goal of scarless surgery remains a challenge.
- Minilaparoscopy-assisted natural orifice surgery (MANOS) presents a viable interim solution.
Purpose of the Study:
- To evaluate the clinical and experimental experience with MANOS.
- To assess the feasibility of MANOS in various abdominal and pelvic procedures.
Main Methods:
- Utilized minilaparoscopic instruments with a large vaginal port for insufflation, visualization, instrument introduction, and specimen retrieval.
- Performed minilaparoscopy-assisted transgastric appendectomy in surgical simulators.
Main Results:
- Successfully applied MANOS in 100 cases since 1998, including gynecological and general surgical procedures.
- Reported only one complication (postoperative fever) in the case series.
- Simulator experience confirmed the feasibility of MANOS for transgastric appendectomies.
Conclusions:
- MANOS serves as a bridge to widespread natural orifice surgery adoption.
- While natural orifice surgery may take years to standardize, MANOS can expedite its integration into clinical practice.
