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Image-guided real-time navigation for transanal total mesorectal excision: a pilot study.

S Atallah1, B Martin-Perez2, S Larach2

  • 1Florida Hospital, Winter Park, FL, USA. atallah@post.harvard.edu.

Techniques in Coloproctology
|July 9, 2015
PubMed
Summary

Frameless stereotactic navigation is feasible for transanal minimally invasive surgery total mesorectal excision (TAMIS-TME). This technology may help surgeons perform safer, high-quality rectal cancer surgery.

Keywords:
NavigationRectal cancerStereotaxyTAMIS-TMETransanal TMEtaTME

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Area of Science:

  • Surgical Navigation
  • Colorectal Surgery
  • Oncology

Background:

  • Frameless stereotaxy is established in neurosurgery and orthopedics.
  • Real-time navigation has been recently applied to transanal total mesorectal excision (TAMIS-TME).

Purpose of the Study:

  • To report the first pilot series on using frameless stereotactic navigation for TAMIS-TME.
  • To assess the feasibility and potential benefits of this technology in rectal cancer surgery.

Main Methods:

  • A pilot study involving three male patients with locally advanced rectal cancer undergoing TAMIS-TME.
  • Utilized a frameless stereotactic navigational system for real-time image guidance during the transanal portion of the surgery.

Main Results:

  • No intra-operative complications were recorded.
  • All surgical specimens showed completely intact mesorectal envelopes with negative margins.
  • Mean postoperative stay was 5 days, with no locoregional recurrence or distant metastasis at 18-month follow-up.

Conclusions:

  • Frameless stereotactic navigation is feasible for TAMIS-TME.
  • The technology may assist colorectal surgeons in achieving safe, high-quality outcomes in select rectal cancer cases.