Transanal rectosigmoidectomy using a single port in a Swine model.

Area of Science:

• Minimally invasive surgery
• Colorectal surgery
• Surgical innovation

Background:

• Natural orifice transluminal endoscopic surgery (NOTES) and single access surgery are emerging techniques to reduce surgical invasiveness.
• This study evaluated the feasibility of NOTES transanal rectosigmoidectomy using a single port in a swine model.

Purpose of the Study:

• To assess the feasibility and safety of single-port NOTES transanal rectosigmoidectomy.
• To evaluate the efficacy of this minimally invasive approach in a preclinical setting.

Main Methods:

• Ten male pigs underwent either a nonsurvival (n=4) or survival (n=6) study.
• A single port was placed transanally after rectal occlusion; dissection was performed with laparoscopic instruments and endoscopic view.
• Colorectal anastomosis was completed using a circular stapler, with necropsies on postoperative day 7 for the survival group.

Main Results:

• Successful full-thickness circumferential rectosigmoid mobilization was achieved in all cases (mean resection length 10 cm).
• No anastomotic defects or mortality were observed in the survival group.
• Minor findings in the survival group included a pelvic abscess in one case and bladder distention in three cases.

Conclusions:

• NOTES transanal rectosigmoidectomy using a single port is demonstrated as feasible and safe.
• Further research, including human cadaver studies, is recommended to advance this technique.