Endo‐Laparoscopic Colectomy Without Mini‐Laparotomy for Left‐Sided Colonic Tumors

Abstract

Our preliminary experience indicates this new technique of endo-laparoscopic colectomy is feasible for selected patients with left-sided colonic tumors. Complications related to mini-laparotomy can be abolished entirely with this hybrid approach.

Laparoscopic sigmoid resection with transrectal specimen extraction has a good short-term outcome

“…With the described technique, there is no need to insert a proctoscope into the rectum to deliver the specimen, as proposed by others, because the specimen size is limited by the diameter of the proctoscope [2,12]. However, the rectum and the anal canal should be protected during specimen extraction due to the risk of tumor seeding.…”

“…A laparoscopic left hemicolectomy and total colectomy with ileorectal anastomosis and transanal specimen extraction have been described by many authors [1,2,[8][9][10][11][12][13]. Even for low rectal cancer, laparoscopic resection with transanal extraction and hand-sewn coloanal anastomosis has been reported previously [14,15].…”

“…The avoidance of any laparotomy could lead to a decrease in surgical stress response, a faster return to normal bowel function and diet, a decrease in postoperative pain, and fewer wound complications and incisional hernias. Various techniques have already been described [1,2], but concerns exist regarding the possibility of tumor seeding in the rectum, and the size of the specimen is limited if a rigid rectal tube is used. The technique presented in this report deals with both shortcomings.…”

Laparoscopic left colectomy combined with natural orifice access: operative technique and initial results

“…Cheung et al [10] have recently described the use of the TEO device to facilitate removal of the specimen. With their techniques, placement of the anvil into the proximal colon is somewhat complicated compared with our technique.…”

NOTES in the management of colorectal diseases: Current experience and future directions

“…In addition to the growing international experience with singleport laparoscopic colorectal resection, laparoscopic colorectal resection using transrectal assistance, where tra nsrectal access is used for specimen extraction [26] , insertion of the anvil of a circular stapler for intracorporeal double stapled anastomosis [27,28] , or both [29] has been described. Transvaginal access has also been used as an extraction site following colorectal resection [30] as well part of a hybrid NOTES laparoscopic rectosigmoid dissection [31] where significant portions of the dissection are performed transvaginally.…”