Transanal endoscopic surgery using single access and standard laparoscopic instrumentation

Area of Science:

• Colorectal surgery
• Minimally invasive surgery
• Surgical technology

Background:

• Transanal endoscopic microsurgery (TEM) and transanal endoscopic operation (TEO) enable precise rectal lesion excision.
• Current TEM/TEO technologies have high costs and require specialized skills, limiting widespread adoption.
• Increasing rectal cancer incidence and advancements in laparoscopic surgery create opportunities for improved transanal techniques.

Purpose of the Study:

• To analyze the potential of single-port minimally invasive surgery (MIS) to overcome barriers in transanal endoscopic microsurgery (TEM).
• To evaluate currently available single-port devices for transanal application.
• To define parameters for integrating single-port techniques into mainstream transanal surgery.

Main Methods:

• Review and analysis of existing single-port surgical devices applicable to transanal procedures.
• Discussion of the convergence of single-port MIS and transanal techniques.
• Identification of ideal parameters for transanal single-port device development and application.

Main Results:

• Single-port MIS offers a potential solution to the high cost and specialized skill requirements of traditional TEM/TEO.
• Adaptation of early-generation single-port devices is needed for optimal transanal use.
• The "Glove TEM Port" is an example of a table-side constructed device for transanal application.

Conclusions:

• The transfer of single-port techniques to transanal surgery holds significant potential for broader integration into clinical practice.
• Careful attention to oncologic standards is crucial as technical capacity increases.
• Further development and analysis of single-port devices are needed to optimize transanal application and overcome current limitations.