[Surgical key points of precision functional sphincter-preserving surgery]

Area of Science:

• Colorectal Surgery
• Surgical Oncology
• Minimally Invasive Surgery

Background:

• Conventional laparoscopic surgery faces challenges in deep pelvic operations for low rectal tumors, risking sphincter damage and incomplete resection.
• Abdominal auxiliary incisions in traditional surgery contribute to postoperative pain and prolonged recovery.

Purpose of the Study:

• To introduce and evaluate Precision Functional Sphincter-Preserving Surgery (PPS) using the Liu's transanal microsurgery system.
• To demonstrate the feasibility of radical tumor resection with simultaneous anal sphincter preservation for low rectal tumors.

Main Methods:

• PPS involves transabdominal preservation of the left colonic artery and pelvic autonomic nerves.
• Transanal microsurgery allows precise tumor localization and resection under direct visualization.
• Specimen extraction through the anus eliminates the need for abdominal incisions.
• Bowel stump anastomosis to the anal canal is performed with vertical mattress sutures.
• A transanal tube is used postoperatively, avoiding the need for a prophylactic stoma.

Main Results:

• PPS facilitates accurate tumor resection and complete preservation of anal sphincter function.
• The transanal approach avoids abdominal incisions, mitigating associated pain and complications.
• Simultaneous preservation of critical structures like the left colonic artery and pelvic nerves is achieved.

Conclusions:

• Precision Functional Sphincter-Preserving Surgery (PPS) offers a viable solution for radical resection of low rectal tumors.
• This technique effectively preserves anal sphincter function and minimizes surgical trauma.
• PPS represents an advancement in minimally invasive techniques for rectal cancer surgery.