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Journal of Gastrointestinal Surgery

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01-10-2008 | ssat plenary presentation

NOTES Rectosigmoid Resection Using Transanal Endoscopic Microsurgery (TEM) with Transgastric Endoscopic Assistance: A Pilot Study in Swine

Authors: Patricia Sylla, Field F. Willingham, Dae K. Sohn, Denise Gee, William R. Brugge, David W. Rattner

Published in: Journal of Gastrointestinal Surgery | Issue 10/2008

Abstract

Introduction

Transanal endoscopic microsurgery (TEM) provides direct endoscopic access to the rectum and peritoneal cavity. The feasibility of natural orifice translumenal endoscopic surgery (NOTES) rectosigmoid resection using TEM was evaluated in swine. Transgastric endoscopic assistance to extend transanal colon mobilization was also investigated. Full-thickness circumferential rectal dissection was performed and extended proximally. After maximal sigmoid mobilization, the specimen was exteriorized and transected, and the proximal colon was stapled to the distal rectum. In a subset of animals, transgastric endoscopic access was used to mobilize the colon further.

Results

Rectosigmoid resection using TEM was performed in two non-survival and seven swine cadavers (n = 9). The mean procedure time was 3 h (2.5–4 h), and mean length of resected colon was 16.7 cm (10–25 cm). Transgastric endoscopic assistance was used in three cadavers and two non-survival swine (n = 5) with a mean operative time of 3.5 h (3.5–3.75 h). The mean length of colon mobilized with transgastric and transanal endoscopic access was 24.4 cm (20–27 cm) vs. 16.7 cm which mobilized the transanal approach alone (p = 0.016). A posterior anastomotic defect was noted in two animals.

Conclusion

Transanal rectosigmoid resection with TEM is feasible in swine. Combined transgastric and TEM access is a promising new technique for NOTES colorectal resection.

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Title: NOTES Rectosigmoid Resection Using Transanal Endoscopic Microsurgery (TEM) with Transgastric Endoscopic Assistance: A Pilot Study in Swine
Authors: Patricia Sylla
Field F. Willingham
Dae K. Sohn
Denise Gee
William R. Brugge
David W. Rattner
Publication date: 01-10-2008
Publisher: Springer-Verlag
Published in: Journal of Gastrointestinal Surgery / Issue 10/2008
Print ISSN: 1091-255X
Electronic ISSN: 1873-4626
DOI: https://doi.org/10.1007/s11605-008-0637-1

Keynote webinar | Spotlight on medication adherence

Springer Medicine

NOTES Rectosigmoid Resection Using Transanal Endoscopic Microsurgery (TEM) with Transgastric Endoscopic Assistance: A Pilot Study in Swine

Abstract

Introduction

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Introduction

Results

Conclusion

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