Related Experiment Video
Updated: Jun 14, 2026
07:22
Surgical Robot-Assisted Transanal Specimen Extraction Radical Sigmoidectomy Without an Auxiliary Abdominal Incision
Published on: June 13, 2025
[Transsigmoid access for NOTES]
H Feussner1, D Wilhelm, A Fiolka
1Chirurgische Klinik und Poliklinik, Klinikum rechts der Isar der TU München, Ismaninger Strasse 22, 81675 München. feussner@chir.med.tu-muenchen.de
Summary
Transsigmoidal access for Natural Orifice Transluminal Endoscopic Surgery (NOTES) offers excellent abdominal access but carries higher risks of contamination and complications. Specialized instruments, similar to transanal endoscopic microsurgery (TEM), are needed for safe and effective procedures.
Area of Science:
- Minimally invasive surgery
- Gastroenterology
- Surgical endoscopy
Context:
- Transsigmoidal access is a novel approach for Natural Orifice Transluminal Endoscopic Surgery (NOTES).
- This method provides broad abdominal access and precise entry point control, irrespective of patient gender.
- Existing data on animal experiments and technical variations are limited.
Purpose:
- To evaluate the feasibility and potential of transsigmoidal access for NOTES procedures.
- To identify challenges and propose solutions for optimizing this surgical approach.
- To highlight the need for specialized instrumentation and techniques.
Summary:
- Transsigmoidal access allows extensive abdominal reach and excellent entry point control for NOTES operations.
- However, this approach is associated with increased risks of contamination, leakage, and complications compared to alternatives.
- Dedicated surgical instruments, potentially adapted from transanal endoscopic microsurgery (TEM) sets, alongside specialized overtubes/trocars and transanal ultrasound, are recommended.
Impact:
- This research informs the development of safer and more effective transsigmoidal access techniques for NOTES.
- It underscores the necessity for advanced instrumentation to mitigate risks and improve procedural outcomes.
- Further research and standardization are crucial for clinical adoption of this promising surgical access method.
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