HYBRID N.O.T.E.S LAPAROSCOPIC FOR MANAGEMENT COLORECTAL CANCER

2014 ◽  
pp. 94-98
Author(s):  
Xuan Loc Duong ◽  
Trong Nhat Phuong Hoang ◽  
Huu Thien Ho ◽  
Hai Thanh Phan ◽  
Nhu Hiep Pham ◽  
...  
Keyword(s):  
Laparoscopic Surgery ◽  
Anterior Resection ◽  
Early Discharge ◽  
Specimen Extraction ◽  
Abdominal Incision ◽  
Laparoscopic Anterior Resection ◽  
Specimen Retrieval ◽  
Discharge From Hospital ◽  
Natural Orifices

Aim: To evaluated the feasibility and initial outcomes application of laparoscopic rectocolectomy with specimen retrieval through natural orifices specimen extraction (N.O.S.E). Material and Method: Prospective, retrospective study in 20 patients were diagnosted sigmoid and rectal cancer and underwent laparoscopic anterior resection, low anterior resection with specimen retrieval through natural orifices specimen extraction (N.O.S.E) at Hue Central Hospital from 2011 to 2013. Results: All cases were successfully performed by laparoscopy. There was no complications during and after operation. Patients felt less pain, had early bowel movement and early discharge from hospital. Conclusions:Our initial experiences showed that laparoscopic surgery with specimen retrieval through natural orifices is feasible. It has full advantages of laparoscopic colectomy otherwise, it prevents an abdominal incision for specimen retrieval. Patient has less pain and short hospitalization. There will be a need for a larger cases study with longer follow-up time to further evaluate the outcome of this method, espencially in oncology. Keywords: colorectal laparoscopic surgery, specimen retrieval transanal.

scholarly journals Transanal Anastomosis Method and Prolapsing Technique in Totally Laparoscopic Low Anterior Resection for Lower Rectal Cancer

2021 ◽  
Vol 105 (1-3) ◽  
pp. 21-25
Author(s):  
Takuya Shiraishi ◽  
Naoki Tomizawa ◽  
Tatsumasa Andoh ◽  
Takuhisa Okada ◽  
Naoya Ozawa
Keyword(s):  
Laparoscopic Surgery ◽  
Anterior Resection ◽  
Low Anterior Resection ◽  
Abdominal Cavity ◽  
Intracorporeal Anastomosis ◽  
Lower Rectal Cancer ◽  
Abdominal Incision ◽  
Laparoscopic Low Anterior Resection ◽  
Double Stapling ◽  
Totally Laparoscopic

There are some reports of totally laparoscopic surgery performed by intracorporeal anastomosis without abdominal incision. However, intracorporeal anastomosis with prolapsing technique is difficult and complicated via laparoscopic surgery alone. We found it easier to achieve totally laparoscopic low anterior resection (LAR) by anastomosis anally. Our procedure was performed in 32 patients. After the prolapsed rectum with the tumor was transected, reconstruction was performed by using a double-stapling technique (DST) or a hand-sewn technique (HST). In the DST, the proximal colon was pulled outside transanally, and the anvil head was inserted into the colon and returned to the abdominal cavity. The anal-side rectum was closed using a linear stapling device, and DST was performed. The HST was modified from intersphincteric resection anastomosis. No patient experienced complications associated with this procedure. Cosmetic satisfaction was achieved. All patients obtained disease-free margins pathologically, and none experienced local recurrence. Intracorporeal anastomosis of totally laparoscopic low anterior resection is difficult via laparoscopic ports only. It can be simplified by operating with anastomosis via the anus.

scholarly journals Reducing invasiveness of laparoscopic surgery using natural orifices and abdominal wall defects for extraction of the specimen

2015 ◽  
Vol 156 (14) ◽  
pp. 552-557
Author(s):  
Péter Lukovich ◽  
Attila Bokor
Keyword(s):  
Inguinal Hernia ◽  
Laparoscopic Surgery ◽  
Abdominal Wall ◽  
Sigmoid Resection ◽  
Abdominal Wall Defects ◽  
Specimen Extraction ◽  
Surgical Specimen ◽  
Laparoscopic Operation ◽  
Transvaginal Specimen Extraction ◽  
Natural Orifices

Introduction: Due to significant technical evolution complex surgeries can be performed laparoscopically nowadays. However, laparotomy is needed frequently for the extraction of the specimen, which decreases the advantages of laparoscopy. Aim: The aim of the authors was to analyse and present their experience on the use of natural orifices and abdominal wall defects for extraction of the surgical specimen. Method: From 2009 the authors used natural orifices (stomach, vagina, rectum) when viscerotomy was an obligate part of laparoscopic surgery and, in a special gastrointestinal laparoscopic operation, the gate of the inguinal hernia for specimen extraction. Results: In 3 patients benign lesions of the stomach were extracted using gastroscope. In 6 patients with bowel endometriosis, in whom the wall of the vagina was completely infiltrated, the resected bowel was extracted transvaginally, and in 5 patients transrectal extraction of the specimen was performed. In 2 patients the inguinal hernia was used for the surgical specimen extraction after laparoscopic sigmoid resection, and in one patient a single-port was inserted into the gate of the hernia during laparoscopic cholecystectomy. Complications occurred only after transvaginal specimen extraction (rectovaginal fistula in 2 patients). Conclusions: Use of natural orifices and abdominal wall defects for surgical specimen extraction further decreases the invasiveness of laparoscopic surgery, if indications made appropriately. Orv. Hetil., 2015, 156(14), 552–557.

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