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Hybrid transanal endoscopic microsurgery: a novel approach to rectal neoplasm excision
A Marrosu1, P Paliogiannis, M W Ruggiu
1Department of Surgical, Microsurgical and Medical Sciences, University of Sassari, Sassari, Italy.
Aim:
Rectal neoplasm excision is a challenging issue in gastrointestinal endoscopy and surgery. This technical note describes a hybrid method for the excision of challenging rectal neoplasms.
Method:
The procedure consists of the combined use of classic endoscopy and transanal endoscopic microsurgical instrumentation for full-thickness removal of a recurrent rectal polyp in a patient who had previously undergone endoscopic excision of a Tis rectal adenocarcinoma, located behind the valve of Houston and 9 cm from the anal verge.
Results:
The lesion was removed completely in 50 min with no operative complication. The patient's postoperative course was uneventful, and she was discharged after 5 days. Pathological examination of the specimen confirmed complete resection of the lesion with adequate disease-free margins.
Conclusion:
Hybrid transanal endoscopic microsurgery successfully combines the precision and flexibility of classic endoscopy with the radicality and safety of transanal endoscopic microsurgery for the treatment of demanding benign or early-stage malignant rectal tumours.
