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[Transanal endoscopic microsurgery].

G Buess, R Theiss, M Günther

    Leber, Magen, Darm
    |November 1, 1985
    PubMed
    Summary
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    A novel endoscopic technique enables precise removal of large rectal and sigmoid adenomas. This method allows for mucosa or full-wall excision, with effective hemorrhage control and defect closure.

    Area of Science:

    • Gastroenterology
    • Surgical Innovation
    • Endoscopic Procedures

    Context:

    • Large sessile adenomas in the rectum and lower sigmoid pose surgical challenges.
    • Existing endoscopic methods may have limitations for extensive tumor removal.
    • Precise surgical intervention is crucial for complete adenoma eradication and patient outcomes.

    Purpose:

    • To introduce and evaluate a new endoscopic surgical method for removing large sessile adenomas.
    • To assess the efficacy and safety of this technique in clinical practice.
    • To demonstrate the capability of precise tumor excision and defect repair.

    Summary:

    • A novel endoscopic surgical method utilizing stereoscopic vision and magnification was developed for large sessile adenomas.
    • The technique allows for mucosa excision for adenomas or complete rectal wall excision for carcinomas.

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  • Hemorrhage control via diathermy and defect closure with continuous suture were consistently achieved in 33 patients.
  • Large areas (up to 10 cm diameter) and locations up to 18 cm into the colon were successfully treated.

    • Impact:

    • This endoscopic approach offers a precise and effective solution for managing large rectal and sigmoid tumors.
    • The technique facilitates complete tumor removal and reliable defect closure, potentially reducing recurrence rates.
    • Successful application in 33 patients demonstrates the clinical feasibility and broad applicability of this innovative surgical method.