Techniques for transanal access to the peritoneal cavity.

Area of Science:

• Minimally Invasive Surgery
• Gastroenterology
• Surgical Innovation

Background:

• Natural orifice translumenal endoscopic surgery (NOTES) is an emerging experimental surgical field.
• The transanal approach is explored as an alternative to transgastric routes for upper abdominal surgeries.
• Transgastric approaches often require cumbersome retroflexion for accessing upper abdominal organs.

Purpose of the Study:

• To review the development of transanal access to the peritoneal cavity.
• To highlight techniques used for transanal access and closure.
• To discuss the advantages and disadvantages of the transanal approach in NOTES.

Main Methods:

• Review of existing literature on transanal endoscopic surgery.
• Analysis of techniques for peritoneal access via the transanal route.
• Evaluation of closure methods for transanal endoscopic procedures.

Main Results:

• The transanal approach provides a more direct route compared to transgastric methods.
• Potential disadvantages include sterility concerns and risks of transmural puncture trauma.
• Risks such as colonic wall shearing are associated with the transanal technique.

Conclusions:

• The transanal approach is a promising but experimental technique in NOTES.
• Careful consideration of sterility and potential trauma is crucial for transanal procedures.
• Further research is needed to optimize transanal access and mitigate associated risks.