gms | German Medical Science

129. Kongress der Deutschen Gesellschaft für Chirurgie

Deutsche Gesellschaft für Chirurgie

24.04. - 27.04.2012, Berlin

Transrectal Single Port Approach: An alternative to NOTES, TEM or ESD

Meeting Abstract

  • Christof Mittermair - Barmherzige Brüder Salzburg, Allgemeinchirurgie, Salzburg
  • Katharina Pimpl - Krankenhaus der Barmherzigen Brüder, Allgemeinchirurgie, Salzburg
  • Christian Obrist - Barmherzige Brüder Salzburg, Allgemeinchirurgie, Salzburg
  • Matthias Biebl - Barmherzige Brüder Salzburg, Allgemeinchirurgie, Salzburg
  • Robert Frass - Barmherzige Brüder Salzburg, Allgemeinchirurgie, Salzburg
  • Nicholas Waldstein - Barmherzige Brüder Salzburg, Allgemeinchirurgie, Salzburg
  • Helmut Weiss - Barmherzige Brüder Salzburg, Allgemeinchirurgie, Salzburg

Deutsche Gesellschaft für Chirurgie. 129. Kongress der Deutschen Gesellschaft für Chirurgie. Berlin, 24.-27.04.2012. Düsseldorf: German Medical Science GMS Publishing House; 2012. Doc12dgch266

DOI: 10.3205/12dgch266, URN: urn:nbn:de:0183-12dgch2662

Published: April 23, 2012

© 2012 Mittermair et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.


Outline

Text

Introduction: For the past 25 years development of both, transanal and endoscopic techniques for resection of local tumours in the rectum have been established. The technique of single port surgery allows an alternate approach utilizing laparoscopic instruments for endolumenal colonic tumour resection. Herein we present the technical aspects of this novel method.

Materials and methods: From November 2010 on we operate on five patients suffering from benign tumours in the mid and low rectum. In all cases endoscopic snare resection was not feasible for length and orientation of the lesion. Patients were placed in lithotomy position and a SILS port (Covidien) was fixed transanally. Using intralumenal carbon-dioxide insufflation, two working instruments and a five millimetre 30° camera were delivered through the port. Submucosal preparation was carried out by means of ultrasonic or monopolar electrocauteric dissection. Closure of the mucosal defect was necessary in one patient. Specimen were sent for pathohistological evaluation.

Results: All resections could be completed successfully, no intraoperative complication was observed. Entire continuity of dissection plane could be achieved. Histological evaluation revealed free resection margins, postoperative recovery of the patients were uneventful.

Conclusion: Transanal resection of large polyps using laparoscopic instruments can, in some cases, be a save and feasible alternative to NOTES, TEM, or ESD.