Laparoscopic intersphincteric resection using needlescopic instruments.

Area of Science:

• Colorectal Surgery
• Minimally Invasive Surgery
• Surgical Oncology

Background:

• Very low rectal cancer poses challenges for preserving anal function.
• Intersphincteric resection (ISR) is a surgical option to maintain anal function.
• Laparoscopic approaches aim to reduce surgical invasiveness.

Purpose of the Study:

• To evaluate the feasibility of laparoscopic intersphincteric resection (Lap ISR) using needlescopic instruments.
• To assess the efficacy of needlescopic instruments in performing Lap ISR for very low rectal cancer.

Main Methods:

• Laparoscopic intersphincteric resection (ISR) performed with needlescopic instruments.
• Standard laparoscopic ports for camera and 5-mm ports for instruments.
• Needlescopic forceps used for dissection and specimen extraction via the anus.
• Hand-sewn coloanal anastomosis and covering ileostomy created.

Main Results:

• Lap ISR was successfully performed in two patients with very low rectal cancer.
• No additional ports were required.
• Conventional 5-mm forceps were not needed as a substitute for needlescopic instruments.
• The procedure demonstrated feasibility for minimally invasive surgery.

Conclusions:

• Needlescopic laparoscopic intersphincteric resection (Lap ISR) is a feasible minimally invasive surgical technique.
• This approach can be effectively utilized for treating very low rectal cancer while preserving anal function.
• Needlescopic instruments offer a viable option for advanced laparoscopic rectal surgery.