Penetration into free abdominal cavity during transanal endoscopic rectal resection for adenoma

Benign and malignant tumors are the most common diseases of the rectum and tend to grow. Various techniques have been developed for the treatment of rectal tumors: endoscopic electroexcision through a colonoscope, transanal removal of tumors, and transabdominal removal. The use of all these methods made it possible to determine their advantages and indications, as well as limitations and disadvantages. Technical advances in modern oncology resulted in developing a method for transanal tumor removal with a number of advantages: radical surgery, adequacy, and functionality. This technique can be used in benign and malignant rectal tumors. One of its main advantages involves a small number of postoperative complications, while intra- operative complications such as penetration into the free abdominal cavity during transanal endoscopic resection of the rectum are quite rare. It is also important that the method of transanal endoscopic resection of the rectum also has good oncological and functional results (according to various studies). We present a clinical case of penetration into the free abdominal cavity during transanal endoscopic rectal resection for adenoma. This case is also interesting in that the patient also had another complication – postoperative bleeding from the rectum, which required surgical intervention, also with the use of a minimally invasive approach.This clinical observation demonstrates successful suturing of penetrating openings into the abdominal cavity arising during transanal endoscopic removal of rectal tumors with the upper pole located above the pelvic peritoneum and effective minimally invasive tactics in the development of postoperative bleeding.

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Diseases of the Skeletal System

Interventional Radiology ◽

10.1093/med/9780190276249.003.0049 ◽

2018 ◽

pp. 652-666

Author(s):

Tamir Friedman ◽

James E. Brown ◽

Keith B. Quencer

Keyword(s):

Minimally Invasive ◽

Patient Care ◽

Surgical Procedures ◽

Malignant Tumors ◽

Appendicular Skeleton ◽

Diverse Group ◽

Minimally Invasive Approach ◽

Invasive Approach ◽

Technical Aspects ◽

System P

Musculoskeletal (MSK) interventions are a diverse group of procedures aimed at both therapeutic and diagnostic arenas for patient care and management. As the field evolves, MSK interventions are offering a minimally invasive approach as an alternative for open surgical procedures, such a biopsies of the axial and appendicular skeleton for diagnostic and treatment purposes, treatment of benign and malignant tumors or spinal interventions for pain or oncology therapies. However, the proceduralist must be adept with anatomy, devices and practices of referring specialties. This chapter will delve into the technical aspects of MSK procedures as well as recommendation and pitfalls of various procedures.

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Transanal minimally invasive surgery for rectal polyps and selected malignant tumors: caution concerning intermediate-term functional results

International Journal of Colorectal Disease ◽

10.1007/s00384-017-2893-6 ◽

2017 ◽

Vol 32 (12) ◽

pp. 1677-1685 ◽

Cited By ~ 12

Author(s):

S. H. E. M. Clermonts ◽

Y. T. van Loon ◽

A. H. W. Schiphorst ◽

D. K. Wasowicz ◽

D. D. E. Zimmerman

Keyword(s):

Minimally Invasive Surgery ◽

Minimally Invasive ◽

Invasive Surgery ◽

Malignant Tumors ◽

Functional Results ◽

Transanal Minimally Invasive Surgery ◽

Rectal Polyps

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Endoscopic resection of intrahepatic septal stenosis: minimally invasive approach to manage hepatolithiasis after choledochal cyst excision

Pediatric Surgery International ◽

10.1007/s00383-006-1756-y ◽

2006 ◽

Vol 22 (11) ◽

pp. 939-941 ◽

Cited By ~ 5

Author(s):

Yasuyuki Ono ◽

Kenitiro Kaneko ◽

Yukio Ogura ◽

Wataru Sumida ◽

Takahisa Tainaka ◽

...

Keyword(s):

Minimally Invasive ◽

Endoscopic Resection ◽

Choledochal Cyst ◽

Minimally Invasive Approach ◽

Invasive Approach ◽

Cyst Excision

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A Single Centre Retrospective Evaluation of Laparoscopic Rectal Resection with TME for Rectal Cancer: 5-Year Cancer-Specific Survival

International Journal of Surgical Oncology ◽

10.1155/2011/473614 ◽

2011 ◽

Vol 2011 ◽

pp. 1-5

Author(s):

Raoul Quarati ◽

Massimo Summa ◽

Fabio Priora ◽

Valeria Maglione ◽

Ferruccio Ravazzoni ◽

...

Keyword(s):

Rectal Cancer ◽

Survival Rate ◽

Minimally Invasive ◽

Rectal Resection ◽

Minimally Invasive Approach ◽

Single Centre ◽

Term Survival ◽

Invasive Approach ◽

Anterior Rectal Resection

Laparoscopic colon resection has established its role as a minimally invasive approach to colorectal diseases. Better long-term survival rate is suggested to be achievable with this approach in colon cancer patients, whereas some doubts were raised about its safety in rectal cancer. Here we report on our single centre experience of rectal laparoscopic resections for cancer focusing on short- and long-term oncological outcomes. In the last 13 years, 248 patients underwent minimally invasive approach for rectal cancer at our centre. We focused on 99 stage I, II, and III patients with a minimum follow-up period of 5 years. Of them 43 had a middle and 56 lower rectal tumor. Laparoscopic anterior rectal resection was performed in 71 patients whereas laparoscopic abdomino-perineal resection in 28. The overall mortality rate was 1%; the overall morbidity rate was 29%. The 5-year disease-free survival rate was 69.7%, The 5-year overall survival rate was 78.8%.

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VP028 TAPP REPAIR FOR INCISIONAL LUMBAR HERNIA

British Journal of Surgery ◽

10.1093/bjs/znab395.159 ◽

2021 ◽

Vol 108 (Supplement_8) ◽

Author(s):

Sónia Ribas ◽

Ana Peixoto Pereira ◽

Conceição Antunes

Keyword(s):

Minimally Invasive ◽

Abdominal Cavity ◽

Lumbar Hernia ◽

Barbed Suture ◽

Invasive Approach ◽

Incisional Hernias ◽

Tapp Repair ◽

Duration Of Surgery ◽

Invasive Techniques

Abstract Aim “Incisional hernias are very common and can present even after minimally invasive surgery for other pathologies. Laparoscopic ventral hernia repair first described by LeBlanc in 1992, gained great popularity, because of its known advantages over the open techniques. In the last decade because of increasing concerns about the future risks of using an intra-peritoneal mesh, several minimally invasive techniques using a mesh outside abdominal cavity have been described. We report the use of a TAPP technique.” Material and Methods “48 yo female patient, that underwent a laparoscopic right adrenalectomy, for myelolipoma, in 2015, with subsequent incisional lumbar hernia (L4W1) in the extraction incision.” Results “The patient was submitted to a laparoscopic TAPP repair in ambulatory surgery with extended recovery. The hernia defect was closed with a barbed suture and it was used a 15x15cm medium weight polypropylene mesh without traumatic fixation. For pain control it was done a TAP block guided by laparoscopy. The duration of surgery was 90 minutes. The patient had no complications. No recurrence on follow-up (4 months).” Conclusions “New minimally invasive procedures for the repair of incisional hernias avoid the intraperitoneal mesh position and maintain all the advantages of the minimally invasive approach. Some of these techniques may be complex and have a long learning curve. TAPP seems reproducible and a good option if a good extra-peritoneal dissection is possible. Larger series are needed, to accurately compare these new techniques with IPOM, open sublay and to select the best technique for each patient.”

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Endoscopy-guided diode laser-assisted transcaruncular StopLoss Jones tube implantation for canalicular obstructions in primary surgery

Graefe s Archive for Clinical and Experimental Ophthalmology ◽

10.1007/s00417-020-04942-y ◽

2020 ◽

Vol 258 (12) ◽

pp. 2809-2817

Author(s):

Yongwei Guo ◽

Alexander C. Rokohl ◽

Katharina Kroth ◽

Senmao Li ◽

Ming Lin ◽

...

Keyword(s):

Minimally Invasive ◽

Diode Laser ◽

Postoperative Bleeding ◽

Primary Treatment ◽

Implantation Technique ◽

Success Rates ◽

Secondary Surgery ◽

Invasive Approach ◽

Primary Surgery ◽

Tube Malposition

Abstract Purpose To introduce and evaluate a minimally-invasive endoscopy-guided transcaruncular laser-assisted StopLoss Jones tube (SLJT) implantation technique for severe canalicular obstructions in primary surgeries. Methods We retrospectively identified 12 adult patients (12 eyes) with severe epiphora secondary to long-segment canalicular obstructions. All the 12 eyes underwent an endoscopy-guided transcaruncular SLJT implantation with an 810-nm diode laser’s assistance as the primary surgical approach. Surgical and functional success rates, intraoperative and postoperative complications, as well as the need for secondary surgery, are evaluated. Results Primary surgical success was achieved in 11 of the 12 cases (92%); one patient (8%) required secondary surgery to replace an SLJT with a shorter one. Ultimately, all cases showed well-placed functioning tubes. Three of the 12 cases (25%) presented conjunctival scarring, conjunctival granulation tissue, with or without tube-associated irritation of the ocular surface. We observed no sink-in, extrusion, nor crack of the tube. Complete functional success was achieved in 83%, and moderate functional success in 17% of all patients. The functionally unsuccessful outcome was not present in this study. Conclusion Endoscopy-guided transcaruncular diode laser-assisted SLJT implantation seems to be a promising minimally invasive approach for primary treatment of severe canalicular dacryostenosis. This novel technique shows high functional success rates. It seems to avoid the risk of tube malposition and extrusion, septal and turbinate injury, nasal adhesion, drainage failure, ethmoiditis, postoperative bleeding, and cutaneous scars.

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ESD-aid Surgery as a New Treatment Strategy for Duodenal Adenoma

10.21203/rs.3.rs-602250/v1 ◽

2021 ◽

Author(s):

Tomotaka Okubo ◽

Ryo Ogawa ◽

Sunao Ito ◽

Shunsuke Hayakawa ◽

Hiroyuki Sagawa ◽

...

Keyword(s):

Minimally Invasive ◽

Abdominal Cavity ◽

Postoperative Bleeding ◽

University Hospital ◽

Duodenal Wall ◽

Duodenal Adenoma ◽

Invasive Treatment ◽

Institutional Review ◽

Delayed Perforation ◽

New Treatment

Abstract BackgroundThe treatment for nonampullary duodenal adenoma remains to have no consensus and established methods. Although endoscopic treatment is minimally invasive, it was reported to cause delayed perforation in more than 20% of cases. MethodsFor adenomas in the duodenum, we have performed ESD-aid surgery, which is a procedure to prophylactically suture the seromuscular structure of the duodenum after ESD. In this procedure, we did not perform Kocher mobilization prior to ESD to facilitate endoscopic resection and full-thickness resection to prevent spread of the tumor and infection to the abdominal cavity. The duodenal wall was reinforced in planes using a suture clip. ResultsOf the 13 cases of duodenal adenoma that underwent ESD-aid surgery at our hospital between April 2018 and December 2020, 1 developed postoperative bleeding, but there was no late perforation. ConclusionsFor duodenal adenomas, ESD-aid surgery was considered a safe and minimally invasive treatment.Trial registrationThis research was approved by the institutional review board of Nagoya City University Hospital, Approval Number: 60-19-0021, Approval Date: 4 June 2019.

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