Incisionless Endo-laparoscopic Colecotmy for Left-sided Colonic Tumors

Background: In performing ¡¥traditional¡¦ laparoscopic colectomy for left-sided colonic tumours, specimen retrieval necessitates a mini-laparotomy which often is the cause and evil of postoperative pain, wound infection as well as other pain related complications. Herein we describe a new technique of endo-laparoscopic anterior resection without abdominal incision, where specimen retrieval and colorectal anastomosis can be safely achieved with the use of the Transanal Endoscopic Operations (TEO) device set-up.
Methods: This incisionless technique involves insertion of the TEO device in the lower rectum and luminal extraction of the specimen via the device. The technique is applicable to patients with small tumours (4cm or less) in the left-sided colon or upper rectum, where transanal construction of stapled colorectal anastomosis is intended.
Results: The technique was attempted in ten patients (male: female 4:6) with median age of 66 years (range: 55 – 81). Five patients suffered from rectosigmoid tumours whereas three patients had lesions in the sigmoid colon. The median operating time was 127.5 minutes (range: 105 – 170) and the median blood loss was 20 ml (range: 20 – 50). The median hospital stay was 7 days (range: 4 – 18), while the median maximum pain score (visual analogue score) was 2 (range: 2 ¡V 3) during in-hospital stay in this small series.
Conclusions: Our preliminary experience indicates this new technique of incisionless endo-laparoscopic colectomy is feasible for selected patients with left-sided colonic tumours. Complications related to mini-laparotomy can be abolished entirely with this by hybrid approach.

Session: Video Channel

Program Number: V059

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