Colorectal anastomotic leakage corrected by transanal laparoscopy

Dapri, Giovanni; Guta, Daniel; Grozdev, Konstantin; Antolino, Laura; Bachir, Najla; Jottard, Katleen; Cadière, Guy-Bernard

doi:10.1111/codi.13358

Cited by 13 publications

(10 citation statements)

References 11 publications

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“…In cases where endoscopic means are incapable of managing the leak, TAMIS via rectal insufflation can be effective[24,25]. This provides an alternate route to access to the distal rectum with use of conventional laparoscopic instruments[26].…”

Section: Discussionmentioning

confidence: 99%

Novel technique for anastomotic salvage using transanal minimally invasive surgery: A case report

Olavarria¹,

Kress²,

Shah³

et al. 2019

WJGS

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BACKGROUND Anastomotic leak (AL) after low anterior resection (LAR) can be a highly morbid complication. The incidence of AL ranges from 5% to 20% depending on patient characteristics and the distance of the anastomosis from the anal verge. Low anastomoses and leaks pose technical challenges for endoscopic treatment. The aim of this report was to describe the use of a commercially available laparoscopic energy device through a transanal minimally invasive surgery (TAMIS) port for the management of a symptomatic leak not requiring relaparotomy (grade B) after a LAR with diverting loop ileostomy. CASE SUMMARY A TAMIS GelPOINT Path port was inserted into the anus to access the distal rectum. Pneumorectum was achieved with AirSeal insufflation and a 30 degree laparoscope was introduced through a trocar. A LigaSure TM Retractable L-Hook device was then used to perform a septotomy of the chronic sinus tract identified posterior to the coloproctostomy. The procedure was then repeated twice in three weeks intervals with ultimate resolution of the chronic leak cavity. Several months after serial TAMIS septotomies, barium enema demonstrated a patent anastomosis with no evidence of persistent leak or stricture. The patient subsequently underwent ileostomy reversal and has had no significant post-operative issues. CONCLUSION TAMIS septotomy with the LigaSure TM Retractable L-Hook is a feasible and effective, minimally invasive salvage technique for the treatment of grade B ALs. Larger studies are needed to assess the generalizability and long-term results of this technique.

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Section: Discussionmentioning

confidence: 99%

Novel technique for anastomotic salvage using transanal minimally invasive surgery: A case report

Olavarria¹,

Kress²,

Shah³

et al. 2019

WJGS

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“…Unlike in Dapr ı et al [1], our patient had already undergone construction of an ileostomy, for protective purposes, at the end of the laparoscopic rectal resection. We discovered the anastomotic leakage during preoperative checks (colonoscopy, CT scan) prior to performing ileostomy reversal.…”

Section: Dear Editormentioning

confidence: 99%

“…We read with interest the article by Dapr ı et al [1] in which two anastomotic leaks occurring after rectal surgery were treated by a transanal approach with a reusable transanal D-port and 5-mm reusable monocurved instruments (DAPRI, Karl-Storz Endoskope). In both cases, anastomotic leakages were repaired by transanal procedures with simultaneous formation of a laparoscopic stoma.…”

Section: Dear Editormentioning

confidence: 99%

“…Even if we need a prospective trial to prove the safety and feasibility of this technique, according to our result and the previous literature we can state that a transanal minimally invasive approach could be adopted in the management of anastomotic leakage. Dear Editor, We read with great interest the article by Foster et al [1], describing an update on current evidence around perineal wound closure after abdominoperineal excision (APE). That article provides an overview of various perineal reconstruction techniques after both conventional and extralevator APE (ELAPE), including primary layered closure and various meshes and flaps.…”

Section: Dear Editormentioning

confidence: 99%

See 1 more Smart Citation

Could a transanal approach be the future treatment for a nonhealing colorectal anastomotic leakage?

Milone

Manigrasso

Venetucci³

et al. 2018

Colorectal Disease

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“…Recently, it underwent an evolution with the application of laparoscopy to surgery of the rectum and rectal diseases, named transanal minimally invasive surgery [3]. Different transanal procedures have been described, like resection of large rectal polyps [4], total mesorectal excision (TME) [5], and the control of perioperative problems like leak, bleeding, and stenosis [6], [7], [8].…”

Section: Introductionmentioning

confidence: 99%

Transanal TME – really needed?

Dapri

2017

Innovative Surgical Sciences

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In the last decade, thanks to natural orifice translumenal endoscopic surgery, the application of laparoscopy through the anus has gained interest from both research and clinical point of views. Therefore, an increased number of transanal procedures have been reported, from the resection of a large rectal polyp to total mesorectal excision, and for controlling perioperative complications like leak, bleeding, and stenosis. Currently, the most popular surgical trend remains transanal total mesorectal excision. In this article, the technique, advantages, and disadvantages are discussed.

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Colorectal anastomotic leakage corrected by transanal laparoscopy

Cited by 13 publications

References 11 publications

Novel technique for anastomotic salvage using transanal minimally invasive surgery: A case report

Novel technique for anastomotic salvage using transanal minimally invasive surgery: A case report

Could a transanal approach be the future treatment for a nonhealing colorectal anastomotic leakage?

Transanal TME – really needed?

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