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Published in: Techniques in Coloproctology 1/2016

01-01-2016 | Challenges in Coloproctology

The quest for precision in transanal total mesorectal excision

Authors: A. G. Franchini Melani, M. Diana, J. Marescaux

Published in: Techniques in Coloproctology | Issue 1/2016

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Abstract

Transanal total mesorectal excision (TME) is an emerging minimally invasive approach to rectal cancer, with encouraging preliminary results. However, the new surgical anatomy of the bottom-up approach complicates surgical understanding and increases the risks of inadvertent injuries to crucial anatomical structures, including nerves. Key elements to improve the safety and stimulate interest in such a complex technique might be robotics and image guidance, to enhance the level of precision. In this editorial, some of the technologies that could be used for precision TME are outlined, in light of the experience of our Institute for Image-Guided Surgery.
Literature
2.
3.
go back to reference Heald RJ, Husband EM, Ryall RD (1982) The mesorectum in rectal cancer surgery: the clue to pelvic recurrence? Br J Surg 69:613–616PubMedCrossRef Heald RJ, Husband EM, Ryall RD (1982) The mesorectum in rectal cancer surgery: the clue to pelvic recurrence? Br J Surg 69:613–616PubMedCrossRef
4.
go back to reference Vennix S, Pelzers L, Bouvy N et al (2014) Laparoscopic versus open total mesorectal excision for rectal cancer. Cochrane Database Syst Rev 4:CD005200PubMed Vennix S, Pelzers L, Bouvy N et al (2014) Laparoscopic versus open total mesorectal excision for rectal cancer. Cochrane Database Syst Rev 4:CD005200PubMed
5.
go back to reference Moriya Y, Sugihara K, Akasu T, Fujita S (1995) Nerve-sparing surgery with lateral node dissection for advanced lower rectal cancer. Eur J Cancer 31A:1229–1232PubMedCrossRef Moriya Y, Sugihara K, Akasu T, Fujita S (1995) Nerve-sparing surgery with lateral node dissection for advanced lower rectal cancer. Eur J Cancer 31A:1229–1232PubMedCrossRef
6.
7.
go back to reference Kim NK, Kim YW, Cho MS (2015) Total mesorectal excision for rectal cancer with emphasis on pelvic autonomic nerve preservation: expert technical tips for robotic surgery. Surg Oncol 24:172–180PubMedCrossRef Kim NK, Kim YW, Cho MS (2015) Total mesorectal excision for rectal cancer with emphasis on pelvic autonomic nerve preservation: expert technical tips for robotic surgery. Surg Oncol 24:172–180PubMedCrossRef
8.
go back to reference Wallner C, Lange MM, Bonsing BA et al (2008) Causes of fecal and urinary incontinence after total mesorectal excision for rectal cancer based on cadaveric surgery: a study from the Cooperative Clinical Investigators of the Dutch total mesorectal excision trial. J Clin Oncol 26:4466–4472PubMedCrossRef Wallner C, Lange MM, Bonsing BA et al (2008) Causes of fecal and urinary incontinence after total mesorectal excision for rectal cancer based on cadaveric surgery: a study from the Cooperative Clinical Investigators of the Dutch total mesorectal excision trial. J Clin Oncol 26:4466–4472PubMedCrossRef
9.
go back to reference Leroy J, Jamali F, Forbes L et al (2014) Laparoscopic total mesorectal excision (TME) for rectal cancer surgery: long-term outcomes. Surg Endosc 18:281–289 Leroy J, Jamali F, Forbes L et al (2014) Laparoscopic total mesorectal excision (TME) for rectal cancer surgery: long-term outcomes. Surg Endosc 18:281–289
11.
go back to reference Marescaux J, Diana M (2015) Next step in minimally invasive surgery: hybrid image-guided surgery. J Pediatr Surg 50:30–36PubMedCrossRef Marescaux J, Diana M (2015) Next step in minimally invasive surgery: hybrid image-guided surgery. J Pediatr Surg 50:30–36PubMedCrossRef
12.
go back to reference Marescaux J, Dallemagne B, Perretta S, Wattiez A, Mutter D, Coumaros D (2007) Surgery without scars: report of transluminal cholecystectomy in a human being. Arch Surg 142:823–826 (discussion 6–7) PubMedCrossRef Marescaux J, Dallemagne B, Perretta S, Wattiez A, Mutter D, Coumaros D (2007) Surgery without scars: report of transluminal cholecystectomy in a human being. Arch Surg 142:823–826 (discussion 6–7) PubMedCrossRef
13.
go back to reference Sylla P, Sohn DK, Cizginer S et al (2010) Survival study of natural orifice translumenal endoscopic surgery for rectosigmoid resection using transanal endoscopic microsurgery with or without transgastric endoscopic assistance in a swine model. Surg Endosc 24:2022–2030PubMedCrossRef Sylla P, Sohn DK, Cizginer S et al (2010) Survival study of natural orifice translumenal endoscopic surgery for rectosigmoid resection using transanal endoscopic microsurgery with or without transgastric endoscopic assistance in a swine model. Surg Endosc 24:2022–2030PubMedCrossRef
14.
go back to reference Sylla P, Willingham FF, Sohn DK, Gee D, Brugge WR, Rattner DW (2008) NOTES rectosigmoid resection using transanal endoscopic microsurgery (TEM) with transgastric endoscopic assistance: a pilot study in swine. J Gastrointest Surg 12:1717–1723PubMedCrossRef Sylla P, Willingham FF, Sohn DK, Gee D, Brugge WR, Rattner DW (2008) NOTES rectosigmoid resection using transanal endoscopic microsurgery (TEM) with transgastric endoscopic assistance: a pilot study in swine. J Gastrointest Surg 12:1717–1723PubMedCrossRef
15.
go back to reference Trunzo JA, Delaney CP (2010) Natural orifice proctectomy using a transanal endoscopic microsurgical technique in a porcine model. Surg Innov 17:48–52PubMedCrossRef Trunzo JA, Delaney CP (2010) Natural orifice proctectomy using a transanal endoscopic microsurgical technique in a porcine model. Surg Innov 17:48–52PubMedCrossRef
16.
go back to reference Whiteford MH, Denk PM, Swanstrom LL (2007) Feasibility of radical sigmoid colectomy performed as natural orifice translumenal endoscopic surgery (NOTES) using transanal endoscopic microsurgery. Surg Endosc 21:1870–1874PubMedCrossRef Whiteford MH, Denk PM, Swanstrom LL (2007) Feasibility of radical sigmoid colectomy performed as natural orifice translumenal endoscopic surgery (NOTES) using transanal endoscopic microsurgery. Surg Endosc 21:1870–1874PubMedCrossRef
17.
go back to reference Wilhelm D, Meining A, von Delius S et al (2007) An innovative, safe and sterile sigmoid access (ISSA) for NOTES. Endoscopy 39:401–406PubMedCrossRef Wilhelm D, Meining A, von Delius S et al (2007) An innovative, safe and sterile sigmoid access (ISSA) for NOTES. Endoscopy 39:401–406PubMedCrossRef
18.
go back to reference Costantino FA, Diana M, Wall J, Leroy J, Mutter D, Marescaux J (2012) Prospective evaluation of peritoneal fluid contamination following transabdominal versus transanal specimen extraction in laparoscopic left-sided colorectal resections. Surg Endosc 26:1495–1500PubMedCrossRef Costantino FA, Diana M, Wall J, Leroy J, Mutter D, Marescaux J (2012) Prospective evaluation of peritoneal fluid contamination following transabdominal versus transanal specimen extraction in laparoscopic left-sided colorectal resections. Surg Endosc 26:1495–1500PubMedCrossRef
19.
go back to reference Funahashi K, Koike J, Teramoto T et al (2009) Transanal rectal dissection: a procedure to assist achievement of laparoscopic total mesorectal excision for bulky tumor in the narrow pelvis. Am J Surg 197:e46–e50PubMedCrossRef Funahashi K, Koike J, Teramoto T et al (2009) Transanal rectal dissection: a procedure to assist achievement of laparoscopic total mesorectal excision for bulky tumor in the narrow pelvis. Am J Surg 197:e46–e50PubMedCrossRef
20.
go back to reference Bertrand MM, Colombo PE, Alsaid B, Prudhomme M, Rouanet P (2014) Transanal endoscopic proctectomy and nerve injury risk: bottom to top surgical anatomy, key points. Dis Colon Rectum 57:1145–1148PubMedCrossRef Bertrand MM, Colombo PE, Alsaid B, Prudhomme M, Rouanet P (2014) Transanal endoscopic proctectomy and nerve injury risk: bottom to top surgical anatomy, key points. Dis Colon Rectum 57:1145–1148PubMedCrossRef
21.
go back to reference Sylla P, Rattner DW, Delgado S, Lacy AM (2010) NOTES transanal rectal cancer resection using transanal endoscopic microsurgery and laparoscopic assistance. Surg Endosc 24:1205–1210PubMedCrossRef Sylla P, Rattner DW, Delgado S, Lacy AM (2010) NOTES transanal rectal cancer resection using transanal endoscopic microsurgery and laparoscopic assistance. Surg Endosc 24:1205–1210PubMedCrossRef
22.
go back to reference de Lacy AM, Rattner DW, Adelsdorfer C et al (2013) Transanal natural orifice transluminal endoscopic surgery (NOTES) rectal resection:”down-to-up” total mesorectal excision (TME)-short-term outcomes in the first 20 cases. Surg Endosc 27:3165–3172PubMedCrossRef de Lacy AM, Rattner DW, Adelsdorfer C et al (2013) Transanal natural orifice transluminal endoscopic surgery (NOTES) rectal resection:”down-to-up” total mesorectal excision (TME)-short-term outcomes in the first 20 cases. Surg Endosc 27:3165–3172PubMedCrossRef
23.
go back to reference Atallah S, Albert M, DeBeche-Adams T, Nassif G, Polavarapu H, Larach S (2013) Transanal minimally invasive surgery for total mesorectal excision (TAMIS-TME): a stepwise description of the surgical technique with video demonstration. Tech Coloproctol 17:321–325PubMedCrossRef Atallah S, Albert M, DeBeche-Adams T, Nassif G, Polavarapu H, Larach S (2013) Transanal minimally invasive surgery for total mesorectal excision (TAMIS-TME): a stepwise description of the surgical technique with video demonstration. Tech Coloproctol 17:321–325PubMedCrossRef
24.
go back to reference Atallah S, Martin-Perez B, Albert M et al (2014) Transanal minimally invasive surgery for total mesorectal excision (TAMIS-TME): results and experience with the first 20 patients undergoing curative-intent rectal cancer surgery at a single institution. Tech Coloproctol 18:473–480PubMedCrossRef Atallah S, Martin-Perez B, Albert M et al (2014) Transanal minimally invasive surgery for total mesorectal excision (TAMIS-TME): results and experience with the first 20 patients undergoing curative-intent rectal cancer surgery at a single institution. Tech Coloproctol 18:473–480PubMedCrossRef
25.
go back to reference Zorron R, Phillips HN, Coelho D, Flach L, Lemos FB, Vassallo RC (2011) Perirectal NOTES access: “down-to-up” total mesorectal excision for rectal cancer. Surg Innov 19:11–19PubMedCrossRef Zorron R, Phillips HN, Coelho D, Flach L, Lemos FB, Vassallo RC (2011) Perirectal NOTES access: “down-to-up” total mesorectal excision for rectal cancer. Surg Innov 19:11–19PubMedCrossRef
26.
go back to reference Leroy J, Diana M, Barry B et al (2012) Perirectal oncologic gateway to retroperitoneal endoscopic single-site surgery (PROGRESSS): a feasibility study for a new NOTES approach in a swine model. Surg Innov 19:345–352PubMedCrossRef Leroy J, Diana M, Barry B et al (2012) Perirectal oncologic gateway to retroperitoneal endoscopic single-site surgery (PROGRESSS): a feasibility study for a new NOTES approach in a swine model. Surg Innov 19:345–352PubMedCrossRef
27.
go back to reference Leroy J, Barry BD, Melani A, Mutter D, Marescaux J (2013) No-scar transanal total mesorectal excision: the last step to pure NOTES for colorectal surgery. JAMA Surg 148:226–230 (discussion 31) PubMedCrossRef Leroy J, Barry BD, Melani A, Mutter D, Marescaux J (2013) No-scar transanal total mesorectal excision: the last step to pure NOTES for colorectal surgery. JAMA Surg 148:226–230 (discussion 31) PubMedCrossRef
28.
go back to reference Araujo SE, Crawshaw B, Mendes CR, Delaney CP (2015) Transanal total mesorectal excision: a systematic review of the experimental and clinical evidence. Tech Coloproctol 19:69–82PubMedCrossRef Araujo SE, Crawshaw B, Mendes CR, Delaney CP (2015) Transanal total mesorectal excision: a systematic review of the experimental and clinical evidence. Tech Coloproctol 19:69–82PubMedCrossRef
29.
go back to reference Tuech JJ, Karoui M, Lelong B et al (2015) A step toward NOTES total mesorectal excision for rectal cancer: endoscopic transanal proctectomy. Am Surg 261:228–233 Tuech JJ, Karoui M, Lelong B et al (2015) A step toward NOTES total mesorectal excision for rectal cancer: endoscopic transanal proctectomy. Am Surg 261:228–233
30.
go back to reference Atallah S, Nassif G, Larach S (2015) Stereotactic navigation for TAMIS-TME: opening the gateway to frameless, image-guided abdominal and pelvic surgery. Surg Endosc 29:207–211PubMedCrossRef Atallah S, Nassif G, Larach S (2015) Stereotactic navigation for TAMIS-TME: opening the gateway to frameless, image-guided abdominal and pelvic surgery. Surg Endosc 29:207–211PubMedCrossRef
31.
go back to reference Atallah S, Martin-Perez B, Larach S (2015) Image-guided real-time navigation for transanal total mesorectal excision: a pilot study. Tech Coloproctol. doi:10.1007/s10151-015-1329-y Atallah S, Martin-Perez B, Larach S (2015) Image-guided real-time navigation for transanal total mesorectal excision: a pilot study. Tech Coloproctol. doi:10.​1007/​s10151-015-1329-y
32.
go back to reference Iseki H, Masutani Y, Iwahara M et al (1997) Volumegraph (overlaid three-dimensional image-guided navigation). Clinical application of augmented reality in neurosurgery. Stereotact Funct Neurosurg 68:18–24PubMedCrossRef Iseki H, Masutani Y, Iwahara M et al (1997) Volumegraph (overlaid three-dimensional image-guided navigation). Clinical application of augmented reality in neurosurgery. Stereotact Funct Neurosurg 68:18–24PubMedCrossRef
33.
go back to reference Wagner A, Ploder O, Enislidis G, Truppe M, Ewers R (1995) Virtual image guided navigation in tumor surgery—technical innovation. J Craniomaxillofac Surg 23:217–223PubMedCrossRef Wagner A, Ploder O, Enislidis G, Truppe M, Ewers R (1995) Virtual image guided navigation in tumor surgery—technical innovation. J Craniomaxillofac Surg 23:217–223PubMedCrossRef
34.
go back to reference D’Agostino J, Diana M, Soler L, Vix M, Marescaux J (2012) 3D virtual neck exploration prior to parathyroidectomy. N Engl J Med 367:1072–1073PubMedCrossRef D’Agostino J, Diana M, Soler L, Vix M, Marescaux J (2012) 3D virtual neck exploration prior to parathyroidectomy. N Engl J Med 367:1072–1073PubMedCrossRef
35.
go back to reference Soler L, Delingette H, Malandain G et al (2000) An automatic virtual patient reconstruction from CT-scans for hepatic surgical planning. Stud Health Technol Inform 70:316–322PubMed Soler L, Delingette H, Malandain G et al (2000) An automatic virtual patient reconstruction from CT-scans for hepatic surgical planning. Stud Health Technol Inform 70:316–322PubMed
36.
go back to reference Marescaux J, Rubino F, Arenas M, Mutter D, Soler L (2004) Augmented-reality-assisted laparoscopic adrenalectomy. JAMA 292:2214–2215PubMed Marescaux J, Rubino F, Arenas M, Mutter D, Soler L (2004) Augmented-reality-assisted laparoscopic adrenalectomy. JAMA 292:2214–2215PubMed
37.
go back to reference Pessaux P, Diana M, Soler L, Piardi T, Mutter D, Marescaux J (2015) Towards cybernetic surgery: robotic and augmented reality-assisted liver segmentectomy. Langenbecks Arch Surg 400:381–385PubMedCrossRef Pessaux P, Diana M, Soler L, Piardi T, Mutter D, Marescaux J (2015) Towards cybernetic surgery: robotic and augmented reality-assisted liver segmentectomy. Langenbecks Arch Surg 400:381–385PubMedCrossRef
38.
go back to reference D’Agostino J, Diana M, Vix M et al (2013) Three-dimensional metabolic and radiologic gathered evaluation using VR-RENDER fusion: a novel tool to enhance accuracy in the localization of parathyroid adenomas. World J Surg 37:1618–1625PubMedCrossRef D’Agostino J, Diana M, Vix M et al (2013) Three-dimensional metabolic and radiologic gathered evaluation using VR-RENDER fusion: a novel tool to enhance accuracy in the localization of parathyroid adenomas. World J Surg 37:1618–1625PubMedCrossRef
39.
go back to reference D’Agostino J, Wall J, Soler L, Vix M, Duh QY, Marescaux J (2013) Virtual neck exploration for parathyroid adenomas: a first step toward minimally invasive image-guided surgery. JAMA Surg 148:232–238 (discussion 8) PubMedCrossRef D’Agostino J, Wall J, Soler L, Vix M, Duh QY, Marescaux J (2013) Virtual neck exploration for parathyroid adenomas: a first step toward minimally invasive image-guided surgery. JAMA Surg 148:232–238 (discussion 8) PubMedCrossRef
40.
go back to reference Marzano E, Piardi T, Soler L et al (2013) Augmented reality-guided artery-first pancreatico-duodenectomy. J Gastrointest Surg 17:1980–1983PubMedCrossRef Marzano E, Piardi T, Soler L et al (2013) Augmented reality-guided artery-first pancreatico-duodenectomy. J Gastrointest Surg 17:1980–1983PubMedCrossRef
41.
go back to reference Diana M, Pessaux P, Marescaux J (2014) New technologies for single-site robotic surgery in hepato-biliary-pancreatic surgery. J Hepato-Biliary Pancreat Sci 21:34–42CrossRef Diana M, Pessaux P, Marescaux J (2014) New technologies for single-site robotic surgery in hepato-biliary-pancreatic surgery. J Hepato-Biliary Pancreat Sci 21:34–42CrossRef
42.
go back to reference Pessaux P, Diana M, Soler L, Piardi T, Mutter D, Marescaux J (2014) Robotic duodenopancreatectomy assisted with augmented reality and real-time fluorescence guidance. Surg Endosc 28:2493–2498PubMedCrossRef Pessaux P, Diana M, Soler L, Piardi T, Mutter D, Marescaux J (2014) Robotic duodenopancreatectomy assisted with augmented reality and real-time fluorescence guidance. Surg Endosc 28:2493–2498PubMedCrossRef
43.
go back to reference Hostettler A, Nicolau SA, Remond Y, Marescaux J, Soler L (2010) A real-time predictive simulation of abdominal viscera positions during quiet free breathing. Prog Biophys Mol Biol 103:169–184PubMedCrossRef Hostettler A, Nicolau SA, Remond Y, Marescaux J, Soler L (2010) A real-time predictive simulation of abdominal viscera positions during quiet free breathing. Prog Biophys Mol Biol 103:169–184PubMedCrossRef
44.
go back to reference Bertrand MM, Macri F, Mazars R, Droupy S, Beregi JP, Prudhomme M (2014) MRI-based 3D pelvic autonomous innervation: a first step towards image-guided pelvic surgery. Eur Radiol 24:1989–1997PubMedCrossRef Bertrand MM, Macri F, Mazars R, Droupy S, Beregi JP, Prudhomme M (2014) MRI-based 3D pelvic autonomous innervation: a first step towards image-guided pelvic surgery. Eur Radiol 24:1989–1997PubMedCrossRef
46.
go back to reference Nachiappan S, Askari A, Currie A, Kennedy RH, Faiz O (2014) Intraoperative assessment of colorectal anastomotic integrity: a systematic review. Surg Endosc 28:2513–2530PubMedCrossRef Nachiappan S, Askari A, Currie A, Kennedy RH, Faiz O (2014) Intraoperative assessment of colorectal anastomotic integrity: a systematic review. Surg Endosc 28:2513–2530PubMedCrossRef
47.
go back to reference Karliczek A, Benaron DA, Baas PC, Zeebregts CJ, Wiggers T, van Dam GM (2010) Intraoperative assessment of microperfusion with visible light spectroscopy for prediction of anastomotic leakage in colorectal anastomoses. Colorectal Dis 12:1018–1025PubMedCrossRef Karliczek A, Benaron DA, Baas PC, Zeebregts CJ, Wiggers T, van Dam GM (2010) Intraoperative assessment of microperfusion with visible light spectroscopy for prediction of anastomotic leakage in colorectal anastomoses. Colorectal Dis 12:1018–1025PubMedCrossRef
48.
go back to reference Karliczek A, Harlaar NJ, Zeebregts CJ, Wiggers T, Baas PC, van Dam GM (2009) Surgeons lack predictive accuracy for anastomotic leakage in gastrointestinal surgery. Int J Colorectal Dis 24:569–576PubMedCrossRef Karliczek A, Harlaar NJ, Zeebregts CJ, Wiggers T, Baas PC, van Dam GM (2009) Surgeons lack predictive accuracy for anastomotic leakage in gastrointestinal surgery. Int J Colorectal Dis 24:569–576PubMedCrossRef
49.
go back to reference Jafari MD, Wexner SD, Martz JE et al (2015) Perfusion assessment in laparoscopic left-sided/anterior resection (PILLAR II): a multi-institutional study. J Am Coll Surg 220:82–92e1PubMedCrossRef Jafari MD, Wexner SD, Martz JE et al (2015) Perfusion assessment in laparoscopic left-sided/anterior resection (PILLAR II): a multi-institutional study. J Am Coll Surg 220:82–92e1PubMedCrossRef
50.
go back to reference Diana M, Agnus V, Halvax P et al (2015) Intraoperative fluorescence-based enhanced reality laparoscopic real-time imaging to assess bowel perfusion at the anastomotic site in an experimental model. Br J Surg 102:e169–e176PubMedCrossRef Diana M, Agnus V, Halvax P et al (2015) Intraoperative fluorescence-based enhanced reality laparoscopic real-time imaging to assess bowel perfusion at the anastomotic site in an experimental model. Br J Surg 102:e169–e176PubMedCrossRef
51.
go back to reference Diana M, Dallemagne B, Chung H et al (2014) Probe-based confocal laser endomicroscopy and fluorescence-based enhanced reality for real-time assessment of intestinal microcirculation in a porcine model of sigmoid ischemia. Surg Endosc 28:3224–3233PubMedCrossRef Diana M, Dallemagne B, Chung H et al (2014) Probe-based confocal laser endomicroscopy and fluorescence-based enhanced reality for real-time assessment of intestinal microcirculation in a porcine model of sigmoid ischemia. Surg Endosc 28:3224–3233PubMedCrossRef
52.
go back to reference Diana M, Halvax P, Dallemagne B et al (2014) Real-time navigation by fluorescence-based enhanced reality for precise estimation of future anastomotic site in digestive surgery. Surg Endosc 28:3108–3118PubMedCrossRef Diana M, Halvax P, Dallemagne B et al (2014) Real-time navigation by fluorescence-based enhanced reality for precise estimation of future anastomotic site in digestive surgery. Surg Endosc 28:3108–3118PubMedCrossRef
53.
go back to reference Diana M, Noll E, Agnus V et al (2015) Reply to Letter: “Enhanced reality fluorescence videography to assess bowel perfusion: the cybernetic eye”. Am Surg PMID 26020109 Diana M, Noll E, Agnus V et al (2015) Reply to Letter: “Enhanced reality fluorescence videography to assess bowel perfusion: the cybernetic eye”. Am Surg PMID 26020109
54.
go back to reference Diana M, Noll E, Diemunsch P et al (2014) Enhanced-reality video fluorescence: a real-time assessment of intestinal viability. Am Surg 259:700–707 Diana M, Noll E, Diemunsch P et al (2014) Enhanced-reality video fluorescence: a real-time assessment of intestinal viability. Am Surg 259:700–707
55.
go back to reference Matsui A, Tanaka E, Choi HS et al (2010) Real-time, near-infrared, fluorescence-guided identification of the ureters using methylene blue. Surgery 148:78–86PubMedPubMedCentralCrossRef Matsui A, Tanaka E, Choi HS et al (2010) Real-time, near-infrared, fluorescence-guided identification of the ureters using methylene blue. Surgery 148:78–86PubMedPubMedCentralCrossRef
56.
go back to reference Dip FD, Nahmod M, Anzorena FS et al (2014) Novel technique for identification of ureters using sodium fluorescein. Surg Endosc 28:2730–2733PubMedCrossRef Dip FD, Nahmod M, Anzorena FS et al (2014) Novel technique for identification of ureters using sodium fluorescein. Surg Endosc 28:2730–2733PubMedCrossRef
57.
go back to reference Korb ML, Huh WK, Boone JD et al (2015) Laparoscopic fluorescent visualization of the ureter with intravenous IRDye800CW. J Minim Invasive Gynecol 22:799–806PubMedCrossRef Korb ML, Huh WK, Boone JD et al (2015) Laparoscopic fluorescent visualization of the ureter with intravenous IRDye800CW. J Minim Invasive Gynecol 22:799–806PubMedCrossRef
58.
go back to reference Cotero VE, Kimm SY, Siclovan TM et al (2015) Improved intraoperative visualization of nerves through a myelin-binding fluorophore and dual-mode laparoscopic imaging. PLoS One 10:e0130276PubMedPubMedCentralCrossRef Cotero VE, Kimm SY, Siclovan TM et al (2015) Improved intraoperative visualization of nerves through a myelin-binding fluorophore and dual-mode laparoscopic imaging. PLoS One 10:e0130276PubMedPubMedCentralCrossRef
59.
go back to reference Dhumane PW, Diana M, Leroy J, Marescaux J (2011) Minimally invasive single-site surgery for the digestive system: a technological review. J Minim Access Surg 7:40–51PubMedPubMedCentral Dhumane PW, Diana M, Leroy J, Marescaux J (2011) Minimally invasive single-site surgery for the digestive system: a technological review. J Minim Access Surg 7:40–51PubMedPubMedCentral
60.
go back to reference Diana M, Chung H, Liu KH et al (2013) Endoluminal surgical triangulation: overcoming challenges of colonic endoscopic submucosal dissections using a novel flexible endoscopic surgical platform: feasibility study in a porcine model. Surg Endosc 27:4130–4135PubMedCrossRef Diana M, Chung H, Liu KH et al (2013) Endoluminal surgical triangulation: overcoming challenges of colonic endoscopic submucosal dissections using a novel flexible endoscopic surgical platform: feasibility study in a porcine model. Surg Endosc 27:4130–4135PubMedCrossRef
Metadata
Title
The quest for precision in transanal total mesorectal excision
Authors
A. G. Franchini Melani
M. Diana
J. Marescaux
Publication date
01-01-2016
Publisher
Springer Milan
Published in
Techniques in Coloproctology / Issue 1/2016
Print ISSN: 1123-6337
Electronic ISSN: 1128-045X
DOI
https://doi.org/10.1007/s10151-015-1405-3

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