Carbon dioxide gas leaks during transanal minimally invasive surgery

Excerpt

Transanal minimally invasive surgery (TAMIS) and transanal total mesorectal excision (TaTME) are mostly performed using a dedicated access device, namely the Gelpoint Path (Applied Medical, Rancho Santa Margarita, CA, USA). The instability or oscillation of the rectal wall due to variance in pneumorectal distension that frustrated early adopters has been addressed by addition of high flow insufflation systems (e.g. Airslea, Conmed, Milford, CT USA) [1] and, more recently, with an insufflation stablization bag (Applied Medical) [2]. By adding consistency of intrarectal gas volume, these greatly improve precision and fluency in intra- and transrectal surgery. …