scholarly journals To clip or not to clip? Invited comment on Wilhelm et al.: Use of self-retaining barbed suture for rectal wall closure in transanal endoscopic microsurgery

2014 ◽  
Vol 18 (9) ◽  
pp. 841-841 ◽  
Author(s):  
A. Arezzo
Keyword(s):  
Transanal Endoscopic Microsurgery ◽  
Rectal Wall ◽  
Barbed Suture ◽  
Use Of Self ◽  
Endoscopic Microsurgery

Use of self-retaining barbed suture for rectal wall closure in transanal endoscopic microsurgery

2014 ◽  
Vol 18 (9) ◽  
pp. 813-816 ◽  
Author(s):  
P. Wilhelm ◽  
P. Storz ◽  
S. Axt ◽  
C. Falch ◽  
A. Kirschniak ◽  
...  
Keyword(s):  
Transanal Endoscopic Microsurgery ◽  
Rectal Wall ◽  
Barbed Suture ◽  
Use Of Self ◽  
Endoscopic Microsurgery

scholarly journals Novel use of the Heald anal stent after transanal endoscopic microsurgery

2011 ◽  
Vol 1 (1) ◽  
pp. 15
Author(s):  
Alun E. Jones ◽  
Guy F. Nash
Keyword(s):  
Transanal Endoscopic Microsurgery ◽  
Rectal Neoplasms ◽  
Rectal Wall ◽  
Pelvic Sepsis ◽  
Defect Closure ◽  
Continuous Suture ◽  
Popular Method ◽  
Minimal Morbidity ◽  
Secondary Intention ◽  
Endoscopic Microsurgery

Distension of the rectum following transanal endoscopic microsurgery (TEMS) increases rectal intra-luminal pressure and may promote pelvic sepsis by contaminating the rectal defect. We describe the first use of a Heald anal stent to decompress the rectum following TEMS. Transanal endoscopic microsurgery (TEMS) is an increasingly popular method of resecting rectal neoplasms with minimal morbidity and mortality. Following excision of the lesion, the defect in the rectal wall is usually repaired by a continuous suture. However there is no evidence to suggest defect closure is superior to leaving this to heal by secondary intention. Distension of the rectum post-operatively increases rectal intra-luminal pressure and may promote pelvic sepsis by contaminating the rectal defect.

Transanal endoscopic microsurgery: results of the first 50 cases

2012 ◽  
Vol 19 (1) ◽  
pp. 45-49
Author(s):  
Narimantas Evaldas SAMALAVIČIUS ◽  
Alfredas KILIUS ◽  
Kęstutis PETRULIS ◽  
Simona LETAUTIENĖ ◽  
Rūta GRIGIENĖ ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Transanal Endoscopic Microsurgery ◽  
Rectal Wall ◽  
Anal Verge ◽  
Abdominal Cavity ◽  
Safety Margin ◽  
Adjuvant Chemoradiotherapy ◽  
Rectal Stricture ◽  
Early Rectal Cancer ◽  
Endoscopic Microsurgery

The aim of the study was to share the experience and first results of implementation of transanal endoscopic microsurgery (TEM) technique for the removal of rectal adenomas, early rectal cancer or rectal stricture in the Center of Oncosurgery, Oncology Institute of Vilnius University. Materials and methods. From October 2009 to October 2011, a total of 50 patients underwent TEM for rectal adenomas, early rectal cancer or rectal stricture. The patients were 25 women and 25 men, 31 to 87 years of age (average 65 years). Rectal lesions were from 0.9 to 7.0 cm in diameter, 3–13 cm from the anal verge. Full thickness excision with 1 cm safety margin was achieved in all cases except two (mucosal excision), followed by closing of the rectal wall defect in one-layer running monocryl 3.0 suture using silver clips. In one case (TEM was performed for T2 rectal cancer), abdominal cavity was penetrated and two-layer closure was preferred. Results. In these series of 50 patients there was 1 (2%) complication (cystitis). No postoperative exitus occurred. The hospitalisation period ranged from 2 to 13 days (average 6 days). Final histology revealed 30 (60%) tubular or villous adenomas, 6 (12%) carcinomas in situ (pTis), 7 (14%) T1, 4 (8%) T2 cancers, and well-differentiated neuroendocrine tumors in 3 (6%) were diagnosed. One patient underwent open partial TME in pT1 group; the tumor was in the upper third of rectum and preoperatively evaluated as pTis disease. In two cases (pT1 group) lymphovascular invasion was present on final pathology, so they were offered a postoperative adjuvant chemoradiotherapy. Other 4 patients in T1 group are under surveillance. All 4 patients with T2 lesions were offered adjuvant chemoradiotherapy, one patient refused further treatment. Conclusions. TEM is an alternative for transanal excision of rectal adenomas and early rectal cancer. Further follow-up is necessary to evaluate the recurrence rate of cancer in invasive cancer patients group.

Design of SMA Actuator Based Access Device for Transanal Endoscopic Microsurgery

2010 ◽  
Vol 2 (2) ◽  
pp. 42-48 ◽  
Author(s):  
Hongyan Luo ◽  
Eric Abel ◽  
Alan Slade ◽  
Zhigang Wang ◽  
Robert Steele
Keyword(s):  
Transanal Endoscopic Microsurgery ◽  
Access Device ◽  
Sma Actuator ◽  
Endoscopic Microsurgery
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