Endoscopic Surgery in the Rectum

Buess, G; Theiss, R; Günther, Manuel; Hutterer, Ferenc; Pichlmaier, H.

doi:10.1055/s-2007-1018451

Cited by 196 publications

(36 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…TEM is a relatively new technique first described in 1985 [26]. It is performed through a 40-mm operating rectoscope with carbon dioxide insufflation to obtain vision.…”

Section: Methodsmentioning

confidence: 99%

Local Excision of Rectal Cancer: Review of Literature

Nastro¹,

Beral²,

Hartley³

et al. 2005

Dig Surg

View full text Add to dashboard Cite

In selected patients, local excision of rectal cancer may be an alternative to radical surgery such as abdominoperineal excision of the rectum or anterior resection. Local excision carries lower mortality and morbidity, without the functional disturbance or alteration in body image that can be associated with radical surgery. There are several techniques of local therapy for rectal cancer, with most experience being available in transanal excision. Transanal endoscopic microsurgery is also used but experience with this newer technique is limited. Patient selection is the most important factor in successful local excision, however specific criteria for selecting patients have not been universally accepted. Review of the published literature is difficult because of the variation in adjuvant therapy regimes and follow-up strategies, as well as results reported in terms of local recurrence and survival rates. There is increasing evidence to suggest that local excision should be restricted to patients with T1 stage rectal cancer without high-risk factors. The place for local excision in patients with T2 or high-risk T1 tumours requires prospective, randomised multi-centre trials comparing radical surgery with local excision, with or without adjuvant therapy.

show abstract

“…TEM is a relatively new technique first described in 1985 [26]. It is performed through a 40-mm operating rectoscope with carbon dioxide insufflation to obtain vision.…”

Section: Methodsmentioning

confidence: 99%

Local Excision of Rectal Cancer: Review of Literature

Nastro¹,

Beral²,

Hartley³

et al. 2005

Dig Surg

View full text Add to dashboard Cite

show abstract

“…With a view to overcoming these problems, Buess et al[7,8,9,10] developed and introduced transanal endoscopic microsurgery (TEM) in 1983. This technique essentially combines the exposure of endoscopy with advanced instrument technology and has emerged as a better technique for middle and upper rectal lesions.…”

Section: Introductionmentioning

confidence: 99%

Transanal Endoscopic Microsurgery: Where Are We Now?

Maslekar¹,

Beral²,

White³

et al. 2006

Dig Surg

View full text Add to dashboard Cite

Aims: This review of literature aimed to assess the role and establish the current status of transanal endoscopic microsurgery (TEM) in the management of benign and malignant rectal lesions. Methods: Areview of the literature was undertaken through the Medline database and by cross-referencing previous publications, thus identifying 54 relevant publications on TEM in the management of rectal lesions. Aggregated results of various parameters were calculated but statistical comparisons deemed unsuitable due to heterogeneity of data. Results: The TEM procedure is associated with good functional results, morbidity of 4% and zero procedure-related mortality. The local recurrence rates after TEM excision is 4.5% (range 0–14) for benign rectal lesions, 6% (0–13) for T₁ cancers, 14% (range 0–50) for T₂ cancers and 20% (range 14–67%) for T₃ cancers. Local recurrences after TEM can be surgically salvaged with good disease free survival rates. Conclusions: The TEM procedure clearly offers the benefits of good exposure of the operative field allowing extremely precise dissection and access to high rectal lesions unresectable by other methods. For pTis and low risk pT₁ lesions, the oncological results are comparable to the more traditional formal resection. The routine use of TEM for high-risk pT₁ and higher stage lesions is not an oncologically sound choice at the present moment.

show abstract

“…We prefer the GelpointPath® port with a flexible sleeve and a gel port for port insertion [1]. This port has the advantage of increased freedom of movement [5].…”

Section: Platformmentioning

confidence: 99%

“…Total mesorectal excision (TME) with trans anal minimal invasive surgery (TAMIS) was developed on the platform of transanal endoscopic microsurgery (TEM) described by Buess and colleagues [1]. It is believed that quality of the rectal cancer specimens can be improved and the challenges faced during deep pelvic dissection can be overcome through this 'bottom-up' technique.…”

Section: Introductionmentioning

confidence: 99%

Transanal total mesorectal excision (TaTME) for inflammatory bowel disease (IBD): review of technique and initial experience

et al. 2017

View full text Add to dashboard Cite

IntroductionTrans anal minimal invasive surgery (TAMIS) is a novel technique gaining popularity in colorectal surgery due to its precision in pelvic dissection and easy accessibility to the distal rectum. Its use in colorectal cancer surgery is well documented although inflammatory bowel disease (IBD) poses a unique set of disease-specific and procedure-related challenges. Unlike in cancer surgery, the wide disease spectrum with varying morphological changes in IBD would require the surgeon to adapt accordingly from port insertion to wound closure. This article describes our experience with the first 60 procedures. MethodologyPatients affected by IBD requiring proctectomy with or without total colectomy from 2013 to 2016 were offered Trans anal total mesorectal excision (TaTME) on a TAMIS and Single Incision Laparoscopy (SILS) combined platform. Airseal ® insufflation on GelpointPath ® platform with monopolar diathermy was used for rectal surgery. A second team using ultrasonic dissection carried out concomitant abdominal dissection. Procedural modifications were adopted based on authors' personal experience. Standard ileoanal S pouch with stapler anastomosis was performed. Surgical time, blood loss and patient demographics were recorded. ResultsAll 60 patients (male -44; median age 42.5; range 19-75) presented during the study period underwent TaTME for the rectal dissection with an 8% conversion rate. Of the total 38 (63%) were done for ulcerative colitis and the perineal phase has taken a median time of 141.8 minutes. Ileo-anal pouch surgery was performed in 27 (45%) patients. Two patients (3.3%) required re-intervention due to complications in the abdominal procedure. Two patients required vacuum dressing for wound closure. ConclusionTaTME is a safe and feasible procedure in IBD surgery. Specific difficulties due to the inflammatory process which results in difficult dissection can be overcome with attention to anatomical details and the use of specific instruments. 1,2 2 2 2

show abstract

Endoscopic Surgery in the Rectum

Cited by 196 publications

References 0 publications

Local Excision of Rectal Cancer: Review of Literature

Local Excision of Rectal Cancer: Review of Literature

Transanal Endoscopic Microsurgery: Where Are We Now?

Transanal total mesorectal excision (TaTME) for inflammatory bowel disease (IBD): review of technique and initial experience

Contact Info

Product

Resources

About