INTRODUCTION: In the case of laparoscopic surgery, it is often very difficult to perform total mesorectal excision and cut the bowel being occluded after irrigating the rectal lumen, particularly in the narrow laparoscopic view of the pelvic cavity. To resolve these problems, we applied our original Rectum Catcher to laparoscopic-assisted high and lower rectal surgery in selected patients, and report our results herein.
MATERIALS AND METHOD: The Rectum Catcher is made of stainless steel (length 40 cm, caliber 7mm), with a circle of diameter 6mm punched out at a distance of 10 mm from the top and covered with a short-cut T-tube (length 1 cm, caliber 6 mm). A vessel tape (width 9 mm, length 120 cm) is inserted into the stainless steel and short-cut T-tube. The Rectum Catcher is inserted in abdominal cavity through the 12-mm assist port (left lower port) and a vessel tape is circled the rectum and pulled to catch it. The Rectum Catcher is useful to grasp lower parts of the rectum and pull it in all directions. In the next step, occluding and irrigating the rectal lumen are performed using the Rectum Catcher at the same time. Then the linear cutter is easily positioned just distal to the Rectum Catcher and the rectum is transected appropriately. Sixty-two patients with rectal cancer were operated laparoscopically using the Rectum Catcher at our hospital.
RESULTS: From September 2007 to August 2009, this study included 62 patients undergoing laparoscopic-assisted high anterior resection (Lap-HAR: 29 patients), low anterior resection (Lap-LAR: 28 patients), and abdominoperineal resection (Lap-APR: 5 patients) for rectal cancer, using the Rectum Catcher. Using the Rectum Catcher, easy maneuverability of the 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 study, the simple Rectum Catcher device is safe and useful for performing laparoscopic assisted rectal surgery.
Program Number: P093