Minilaparoscopy-assisted transrectal low anterior resection (LAR): a preliminary study

Area of Science:

• Surgical Oncology
• Minimally Invasive Surgery
• Gastrointestinal Surgery

Background:

• Natural orifice translumenal endoscopic surgery (NOTES) advances surgical techniques toward reduced invasiveness.
• The transrectal approach in NOTES has demonstrated increasing clinical applicability for colorectal procedures.
• This study introduces a novel minilaparoscopy-assisted transrectal low anterior resection with double purse-string anastomoses.

Observation:

• Three patients with rectal cancer underwent transrectal minilaparoscopy-assisted NOTES total mesorectal excision.
• Oncologic principles were strictly adhered to, with two patients receiving neoadjuvant therapy.
• Laparoscopic assistance utilized a 10-mm umbilical port and two smaller ports for stoma and drain sites.

Findings:

• Mean operative time was 143 minutes, with patients discharged by postoperative day 5.
• Pathology confirmed tumor-free margins and satisfactory mesorectal resection quality.
• One patient experienced readmission for dehydration but recovered without complications.

Implications:

• Transrectal minilaparoscopy-assisted low anterior resection is a feasible and safe preliminary surgical option.
• Lateral/end-to-end anastomoses present a viable alternative to standard double-stapling techniques.
• Further research and patient selection are crucial for establishing this technique in routine clinical practice.