Transvaginal resection of a rectal leiomyoma: A case report

Abstract

Abstract. The present study reports the case of a patient with a rectal submucosal tumor (leiomyoma) that was resected transvaginally. A 51-year-old female presented with a rectal submucosal tumor on the anterior wall of the lower rectum, located within 3 cm of the anal verge. This location would normally require intersphincteric or abdominal perineal resection. However, in order to minimize the invasiveness of the treatment and reduce post-operative morbidity, transvaginal resection and laparoscopic diverting ileostomy were performed instead. With the patient under general anesthesia, the posterior vaginal mucosa was incised vertically. The tumor was then excised en bloc with the overlying rectovaginal septum and rectal submucosal tumor. A primary repair of the defect and a diverting stoma were performed. The procedure did not present any complications, and the patient was discharged on day 10 post-surgery. The diverting stoma was closed 3 months later, and the sphincter function of the patient following surgery was monitored by manometry. The results of the manometric tests indicated that the patient did not suffer from fecal incontinence. In addition, the patient did not experience anal dysfunction or discomfort following the surgical procedure.

GelPOINT single-port laparoscopy-assisted transanal minimum invasive surgery for low rectal cancer: a preliminary report on the use of the GOD VISION wireless smart glass-shaped monitor

“…In TaTME and TAMIS, the operator positioned between the patient's legs with the patient in the lithotomy position. New methods and medical equipment to reduce the patient's burden are researched and developed every day [10,11]. The GOD VISION system was developed as a glassesshaped monitor worn by the operator that obviates the need to look at the monitor during laparoscopic surgery and which thereby reduces positional discomfort.…”

A rare case of leiomyoma of the internal anal sphincter

“…The authors preferred this type of approach to reduce the risks of potential anal dysfunction. They also performed a laparoscopic diverting ileostomy subsequently closed after three months [17] . In our case the authors preferred the perineal approach because the tumour is raised from the internal anal sphincter, very close to the skin, and there was no other way of sphincter-saving surgical excision.…”

Robotic and transvaginal excision of rectal leiomyoma – a video vignette

“…The robotic approach allowed a precise and careful dissection of the lesion located in the lower rectum. The transvaginal approach allowed the dislocation of the lesion in a less traumatic way and with better exposure of the surgical field [3]. Both the anterior wall of the rectum and the posterior wall of the vagina were sutured without complications, and a diverting ileostomy was performed in the right iliac fossa.…”

“…Since most PSHs are asymptomatic they can be treated conservatively[1,2]. However, leakage, pain and discomfort from ill-fitting appliances adversely affect quality of life, necessitating surgery[3].Surgical repair of a PSH is challenging owing to high recurrence and surgery-related complication rates [4]. Primary suture repair has a recurrence rate of up to 50% [4].…”