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Surgical Endoscopy

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01-01-2013 | Technique

Minilaparoscopy-assisted transrectal low anterior resection (LAR): a preliminary study

Authors: Antonio M. Lacy, Cedric Adelsdorfer, Salvadora Delgado, Patricia Sylla, David W. Rattner

Published in: Surgical Endoscopy | Issue 1/2013

Abstract

Background

Natural orifice translumenal endoscopic surgery (NOTES) represents the evolution of surgery towards less invasive procedures. The feasibility of NOTES transrectal approach has increased its clinical applicability. This report describes a first series of minilaparoscopy-assisted transrectal low anterior resection with double purse-string end-to-end circular stapler anastomoses.

Methods

Between March and April 2012 three selected patients underwent transrectal minilaparoscopy-assisted natural orifice surgery total mesorectal excision for rectal cancer. All the oncologic principles of open/laparoscopic low anterior resection for rectal cancer were strictly fulfilled. Two patients underwent neoadjuvant treatment. Laparoscopic visualization and assistance was provided through one 10-mm umbilical port and two ports, one of which was used as stoma site (5 mm) and the other as a drain site (2 mm needle port). The specimen was transected transanally followed by the confection of double purse-string lateral/end-to-end anastomoses. There were no intraoperative complications.

Results

Mean operative time was 143 min. Oral intake was initiated on the second postoperative day. Patients were discharged home by day 5. The pathology unit confirmed that distal and circumferential margins were free of tumor invasion, and quality of mesorectum resection was reported satisfactory. One patient had to be readmitted because of severe dehydration due to increased ileostomy output. The patient was discharged at the third day after the readmission without renal failure.

Conclusions

In this preliminary report, transrectal minilaparoscopy-assisted low anterior resection was feasible and safe. Lateral/end-to-end anastomoses can be considered an interesting alternative to the double-stapling technique. However, it is necessary to further study and develop these procedures, along with careful patient selection, before transrectal low anterior resection may be considered for routine clinical use.

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Title: Minilaparoscopy-assisted transrectal low anterior resection (LAR): a preliminary study
Authors: Antonio M. Lacy
Cedric Adelsdorfer
Salvadora Delgado
Patricia Sylla
David W. Rattner
Publication date: 01-01-2013
Publisher: Springer-Verlag
Published in: Surgical Endoscopy / Issue 1/2013
Print ISSN: 0930-2794
Electronic ISSN: 1432-2218
DOI: https://doi.org/10.1007/s00464-012-2443-9

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Minilaparoscopy-assisted transrectal low anterior resection (LAR): a preliminary study

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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