Single incision laparoscopic surgery - trans anal endoscopic microsurgery: A technological innovation

Area of Science:

• Colorectal Surgery
• Minimally Invasive Surgery
• Gastrointestinal Endoscopy

Background:

• Transanal endoscopic microsurgery (TEM) is an established technique for rectal procedures.
• Laparoscopic surgery, including single incision laparoscopic surgery (SILS), has advanced general and gastrointestinal surgery.

Purpose of the Study:

• To report the experience of using SILS techniques for TEM in two patients with large sessile villous adenomas of the rectum.
• To evaluate the feasibility and potential of this novel SILS-TEM approach.

Main Methods:

• Two patients with large rectal adenomas underwent TEM using a SILS port fixed transanally.
• Carbon dioxide insufflation and a telescope were used through the SILS port for visualization and dissection.
• Complete polyp excision was performed, followed by undermining rectal edges to facilitate closure.

Main Results:

• SILS-TEM was successfully performed in two cases of large sessile villous adenomas.
• Histopathological examination confirmed well-differentiated villous adenoma in both excised specimens.
• The technique allowed for complete removal of the adenomas with clear exposure of the circular muscle.

Conclusions:

• Adapting SILS techniques for TEM is a novel and promising approach for treating large rectal adenomas.
• This SILS-TEM method may represent a future advancement in anorectal surgery.
• Further research is warranted to explore the full potential of SILS-TEM for various rectal conditions, including early-stage cancers.