Insufflation stabilization bag (ISB): a cost-effective approach for stable pneumorectum using a modified CO₂ insufflation reservoir for TAMIS and taTME

Excerpt

The rapid evolution of transanal total mesorectal excision (taTME) and transanal minimally invasive surgery (TAMIS) produced unparalleled challenges for traditional insufflation platforms compared with their intended use in the larger peritoneal cavity. The small extraluminal operating volume in conjunction with the safety limitations of the device restricts continuous flow during programmed pauses for pressure sensing. This creates a billowing of the rectum which makes dissection difficult and imprecise [1‐3]. Although standard laparoscopic insufflators have been utilized in order to create a pneumorectum, incomplete distention of the rectum and smoke accumulation are common obstacles [1]. Though the introduction of Airseal (Conmed, Milford, CT, USA) resolved this technical issue, the higher cost of this device ultimately limits its widespread adoption for the transanal approach in the management of rectal neoplasms [1, 2]. …