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Robot-assisted Total Mesorectal Excision and Lateral Pelvic Lymph Node Dissection for Locally Advanced Middle-low Rectal Cancer
Published on: February 12, 2022
Perirectal NOTES access: "down-to-up" total mesorectal excision for rectal cancer
Ricardo Zorron1, Henrique Neubarth Phillips, Djalma Coelho
1University Hospital Teresopolis HCTCO FESO, Rio de Janeiro, Brazil. rzorron@terra.com.br
Surgical Innovation
|July 12, 2011
Summary
Transcolonic natural orifice transluminal endoscopic surgery (NOTES) shows promise for rectal cancer treatment. This minimally invasive approach facilitated successful transrectal total mesorectal excision in two patients.
Area of Science:
- Minimally invasive surgery
- Colorectal surgery
- Endoscopic surgery
Background:
- Natural orifice transluminal endoscopic surgery (NOTES) is an emerging minimally invasive technique.
- Current NOTES applications primarily utilize vaginal or oral access for abdominal procedures.
- Transcolonic NOTES offers a novel access route for colorectal interventions.
Observation:
- The study reports on two patients with rectal adenocarcinoma undergoing transcolonic NOTES.
- A transrectal total mesorectal excision and rectosigmoidectomy with lymphadenectomy was performed.
- Procedures utilized a "down-to-up" dissection with either a flexible scope or a single port device, with transanal specimen extraction and transorificial anastomosis.
Findings:
- Both procedures were completed successfully without complications.
- Operative times were 350 and 360 minutes.
- Patients were discharged after 6 days, indicating a favorable short-term recovery.
Implications:
- Transcolonic NOTES represents a potentially significant advancement in treating colorectal diseases.
- This approach may offer improved patient care compared to traditional surgical methods.
- Further research into transorificial single port or flexible perirectal NOTES is warranted.
