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The Pocket-Creation Procedure of Endoscopic Submucosal Dissection for Large Rectal Laterally Spreading Tumors

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A new proctoscope for transanal endoscopic operations.

J J Ribeiro da Rocha¹, O Féres

¹Faculty of Medicine of Ribeirão Preto, University of São Paulo, São Paulo, Brazil. jjrocha1@bol.com.br

Techniques in Coloproctology

|August 6, 2008

Summary

This study introduces a new, low-cost surgical proctoscope for transanal endoscopic excision of rectal lesions. The device enables effective local excision of various rectal tumors, offering a cost-efficient alternative to existing methods.

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Area of Science:

Colorectal Surgery
Surgical Innovation
Gastroenterology

Background:

Transanal access is a key method for rectal cancer treatment.
Existing techniques for local excision include conventional transanal excision and transanal endoscopic approaches.
There is a need for cost-effective tools for these procedures.

Purpose of the Study:

To present a novel surgical proctoscope designed for endoscopic transanal excision of rectal lesions.
To evaluate the efficacy and cost-effectiveness of this new device.

Main Methods:

A cylindrical proctoscope (4 cm diameter) with a beveled, rounded tip was devised and constructed.
The proctoscope features a fixation mechanism, integrated fiber-light illumination, and an insertion guide.
The device was utilized in excisions of various rectal lesions, including adenomas and adenocarcinomas.

Main Results:

The new proctoscope facilitated the excision of 17 adenomas, 25 adenocarcinomas, 1 carcinoid, and 1 endometrioma.
Lesion diameters ranged from 1 to 6 cm.
The range of procedures achievable was comparable to conventional techniques.

Conclusions:

The newly devised low-cost proctoscope is an efficient instrument for transanal endoscopic excision of rectal lesions.
This device provides a cost-effective alternative to more expensive conventional equipment.
The proctoscope allows for effective local excision of diverse rectal pathologies.