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Updated: Feb 28, 2026

Clinical Application of Single-Surgeon, Three-Port, Laparoscopic Resection for Colorectal Cancer with Natural Orifice Specimen Extraction
Published on: March 24, 2023
'Natural orifice' transcolostomy full-thickness excision of colonic tumour
1Department of Surgery, Division of Colon and Rectal Surgery, Southcoast Health, New Bedford, Massachusetts; Department of Medical Science, Section of Medical Education, Alpert Medical School of Brown University, Rhode Island, USA.
Abstract:
This technical note describes a novel technique, not previously found in the surgical or endoscopic literature: A combined endoscopic and surgical approach to perform a full-thickness excision of a colonic tumour. At the time of colonoscopy via stoma, a large sessile polyp in the descending colon was detected but could not be safely resected endoscopically. The lesion was exteriorised by prolapsing the distal colon through the colostomy, then excised surgically with adequate margins in a full-thickness fashion. This approach was more complete than an endoscopic approach and less invasive than a segmental colectomy and redo colostomy. It may prove useful to surgical endoscopists facing a similar clinical situation in their practice.
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