Transanal Resection of the Recto-sigmoid Colon: Feasibility Study for a Natural Orifices Transluminal Endoscopic Surgery Technique Based on the Principles of Transanal Endoscopic Microsurgery

摘要

BackgroundSince 2004, a new concept for performing surgery without the trauma and the consequence of abdominal incision has emerged as Natural Orifices Transluminal Endoscopic Surgery (NOTES). Though the nomenclature is new but the concept has been in existence for almost three decades in the form of Transanal Endoscopic Microsurgery (TEM) developed by our group. After successful instrument design, experimental study and clinical application of transvaginal cholecystectomy, we have set out for major organ resections like recto-sigmoidal resection through the anus. We believe that the principles of TEM technology are suitable for major NOTES technique like recto-sigmoidal resection with radical lymphadenectomy and primary anastomosis. The technique has the potential of avoiding minilaparotomy and port site related trauma during laparoscopic colorectal surgery.