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Related Experiment Video

Updated: Jun 12, 2026

Clinical Application of Single-Surgeon, Three-Port, Laparoscopic Resection for Colorectal Cancer with Natural Orifice Specimen Extraction

Clinical Application of Single-Surgeon, Three-Port, Laparoscopic Resection for Colorectal Cancer with Natural Orifice Specimen Extraction

Published on: March 24, 2023

Trilumenal hybrid-NOS proctocolectomy.

Wolfram Lamadé¹, Christoph Ulmer, Jürgen Hochberger

¹Department for General, Gastrointestinal and Trauma Surgery, Robert-Bosch-Krankenhaus, Stuttgart, Germany. wolfram.lamade@rbk.de

Surgical Innovation

|May 28, 2010

Summary

This summary is machine-generated.

Trilumenal natural orifice surgery (NOS) proctocolectomy is a feasible and safe approach for complex bowel operations. This technique overcomes triangulation limitations in single-lumen procedures, enabling restorative J-pouch reconstruction.

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Published on: July 25, 2025

Area of Science:

Minimally invasive surgery
Gastrointestinal surgery
Surgical innovation

Background:

Complex bowel operations pose surgical challenges.
Natural orifice surgery (NOS) offers a minimally invasive alternative.
Combining multiple orifices (transumbilical, transvaginal, transrectal) may enable advanced procedures.

Purpose of the Study:

To investigate the feasibility and safety of trilumenal NOS for proctocolectomy with J-pouch reconstruction.
To evaluate a novel approach for complex colorectal surgery.

Main Methods:

Retrospective analysis of 30 NOS operations.
Three female patients with ulcerative colitis underwent proctocolectomy with J-pouch reconstruction using a trilumenal NOS approach.
Specimen retrieval via anus and J-pouch preparation through a small incision.

Main Results:

Proctocolectomy with J-pouch reconstruction was successfully performed in 3 patients using the trilumenal NOS technique.
The procedure allowed for specimen retrieval through the anus and pouch creation via a small incision.
No complications were reported in the context of the NOS approach.

Conclusions:

Trilumenal NOS proctocolectomy is a feasible and safe surgical option.
This technique provides a solution for the lack of triangulation inherent in single-lumen NOS approaches.
It facilitates complex procedures like restorative J-pouch reconstruction.