Akiyo Matsumoto, MD, Kaida Arita, MD, Masaki Tashiro, MD, Shigeo Haruki, MD, Shinsuke Usui, MD, Susumu Hiranuma, MD. Tsuchiura Kyodo General Hospital
BACKGROUND: This report describes our experience in 15 patients with lower rectal cancer along with a general overview of the use of the simple Rectum Catcher device and an intraoperative colonofiberscopy in laparoscopic-assisted low and ultralow rectal surgery.
MATERIALS AND METHODS: We reported that the Rectum Catcher was a safe and useful device for performing laparoscopic assisted rectal surgery (Surg Endosc 22:1905-1909, 2008). Recently we have tried the low and ultralow rectal surgery for lower rectal cancer, using the Rectum Catcher and an intraoperative colonofiberscopy. The rectum is grasped using the Rectum Catcher at the proximal margin of the rectum and the location of the cancer is confirmed using an intraoperative colonofiberscopy. In the next step, the Rectum Catcher is applied at the distal margin of the rectum, which easily occludes the rectum, and we confirm that the tumor is not at the distal rectum using an intraoperative colonofiberscopy. Then the rectal lumen is irrigated with 1.0 L povidone-iodine solution. Then the Echelon 60 mm gold (Ethicon Endo Surgery) is positioned just distal to the Rectum Catcher and the rectum is transected.
RESULTS: From January 2009 to the present, this study included 15 patients (7 man and 8 women) undergoing laparoscopic-assisted low and ultralow anterior resection for lower rectal cancer, using the Rectum Catcher and an intraoperative colonofiberscopy. Using the Rectum Catcher and an intraoperative colonofiberscopy, we can easily make a decision of the location of rectal cancer in lower rectum and irrigation of rectal lumen can be easily performed to safely cut the bowel being occluded, in the narrow laparoscopic view of the pelvic cavity.
CONCLUSION: In our experience, The Rectum Catcher and an intraoperative colonofiberscopy are safe and useful for performing laparoscopic-assisted low and ultralow rectal surgery.
Program Number: P109