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Current experience and future directions of completely NOTES colorectal resection 被引量:9

Current experience and future directions of completely NOTES colorectal resection
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摘要 Clinical implementation and widespread application of natural orifice translumenal surgery(NOTES) has been limited by the lack of specialized endoscopic equipment,which has prevented the ability to perform complex procedures including colorectal resections.Relative to other types of translumenal access,transanal NOTES using transanal endoscopic microsurgery(TEM) prov ides a stable platform for endolumenal and direct translumenal access to the peritoneal cavity,and specifically to the colon and rectum.Completely NOTES transanal rectosigmoid resection using TEM,with or without transgastric endoscopic assistance,was demonstrated to be feasible and safe in a swine survival model.The same technique was successfully replicated in human cadavers using commercially available TEM,with endoscopic and laparoscopic instrumentation.This approach also permitted complete rectal mobilization with total mesorectal excision to be performed completely transanally.As in the swine model,transgastric and/or transanal endoscopic assistance extended the length of proximal colon mobilized and overcame some of the difficulties with TEM dissection including limited endoscopic visualization and maladapted instrumentation.This extensive laboratory experience with NOTES transanal rectosigmoid resection served as the basis for the first human NOTES transanal rectal cancer excision using TEM and laparoscopic assistance.Based on this early clinical experience,NOTES transanal approach using TEM holds significant promise as a safe and substantially less morbid alternative to conventional colorectal resection in the management of benign and malignant colorectal diseases.Careful patient selection and substantial improvement in NOTES instrumentation are critical to optimize this approach prior to widespread clinical application,and may ultimately permit completely NOTES transanal colorectal resection. Clinical implementation and widespread application of natural orifice translumenal surgery (NOTES) has been limited by the lack of specialized endoscopic equipment, which has prevented the ability to perform complex procedures including colorectal resections. Relative to other types of translumenal access, transanal NOTES using transanal endoscopic microsurgery (TEM) provides a stable platform for endolumenal and direct translumenal access to the peritoneal cavity, and specifically to the colon and rectum. Completely NOTES transanal rectosigmoid resection using TEM, with or without transgastric endoscopic assistance, was demonstrated to be feasible and safe in a swine survival model. The same technique was successfully replicated in human cadavers using commercially available TEM, with endoscopic and laparoscopic instrumentation. This approach also permitted complete rectal mobilization with total mesorectal excision to be performed completely transanally. As in the swine model, transgastric and/or transanal endoscopic assistance extended the length of proximal colon mobilized and overcame some of the difficulties with TEM dissection including limited endoscopic visualization and maladapted instrumentation. This extensive laboratory experience with NOTES transanal rectosigmoid resection served as the basis for the first human NOTES transanal rectal cancer excision using TEM and laparoscopic assistance. Based on this early clinical experience, NOTES transanal approach using TEM holds significant promise as a safe and substantially less morbid alternative to conventional colorectal resection in the management of benign and malignant colorectal diseases. Careful patient selection and substantial improvement in NOTES instrumentation are critical to optimize this approach prior to widespread clinical application, and may ultimately permit completely NOTES transanal colorectal resection.
机构地区 Department of Surgery
出处 《World Journal of Gastrointestinal Surgery》 SCIE CAS 2010年第6期193-198,共6页 世界胃肠外科杂志(英文版)(电子版)
关键词 COLORECTAL diseases TRANSANAL ENDOSCOPIC MICROSURGERY Natural ORIFICE translumenal ENDOSCOPIC surgery Colorectal diseases Transanal endoscopic microsurgery Natural orifice translumenal endoscopic surgery
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参考文献32

  • 1Patricia Sylla,Dae Kyung Sohn,Sevdenur Cizginer,Yusuf Konuk,Brian G. Turner,Denise W. Gee,Field F. Willingham,Maylee Hsu,Mari Mino-Kenudson,William R. Brugge,David W. Rattner.Survival study of natural orifice translumenal endoscopic surgery for rectosigmoid resection using transanal endoscopic microsurgery with or without transgastric endoscopic assistance in a swine model[J]. Surgical Endoscopy . 2010 (8)
  • 2Gustavo Salinas,Lil Saavedra,Hellen Agurto,Rosa Quispe,Edwin Ramírez,José Grande,Juan Tamayo,Victoria Sánchez,Daniel Málaga,Jeffrey M. Marks.Early experience in human hybrid transgastric and transvaginal endoscopic cholecystectomy[J]. Surgical Endoscopy . 2010 (5)
  • 3Patricia Sylla,David W. Rattner,Salvadora Delgado,Antonio M. Lacy.NOTES transanal rectal cancer resection using transanal endoscopic microsurgery and laparoscopic assistance[J]. Surgical Endoscopy . 2010 (5)
  • 4Santiago Horgan,John P. Cullen,Mark A. Talamini,Yoav Mintz,Alberto Ferreres,Garth R. Jacobsen,Bryan Sandler,Julie Bosia,Thomas Savides,David W. Easter,Michelle K. Savu,Sonia L. Ramamoorthy,Emily Whitcomb,Sanjay Agarwal,Emily Lukacz,Guillermo Dominguez,Pedro Ferraina.Natural orifice surgery: initial clinical experience[J]. Surgical Endoscopy . 2009 (7)
  • 5Hester Y. S. Cheung,Alex L. H. Leung,C. C. Chung,Dennis C. K. Ng,Michael K. W. Li.Endo-Laparoscopic Colectomy Without Mini-Laparotomy for Left-Sided Colonic Tumors[J]. World Journal of Surgery . 2009 (6)
  • 6Joel Leroy,Ronan A. Cahill,Silvana Perretta,Antonello Forgione,Bernard Dallemagne,Jacques Marescaux.Natural orifice translumenal endoscopic surgery (NOTES) applied totally to sigmoidectomy: an original technique with survival in a porcine model[J]. Surgical Endoscopy . 2009 (1)
  • 7Patricia Sylla,Field F. Willingham,Dae K. Sohn,Denise Gee,William R. Brugge,David W. Rattner.NOTES Rectosigmoid Resection Using Transanal Endoscopic Microsurgery (TEM) with Transgastric Endoscopic Assistance: A Pilot Study in Swine[J]. Journal of Gastrointestinal Surgery . 2008 (10)
  • 8Antonio M. Lacy,Salvadora Delgado,Oscar A. Rojas,Raúl Almenara,Anabel Blasi,Josep Llach.MA-NOS radical sigmoidectomy: report of a transvaginal resection in the human[J]. Surgical Endoscopy . 2008 (7)
  • 9R. Zorron,L. C. Maggioni,L. Pombo,A. L. Oliveira,G. L. Carvalho,M. Filgueiras.NOTES transvaginal cholecystectomy: preliminary clinical application[J]. Surgical Endoscopy . 2008 (2)
  • 10M. H. Whiteford,P. M. Denk,L. L. Swanstr?m.Feasibility of radical sigmoid colectomy performed as natural orifice translumenal endoscopic surgery (NOTES) using transanal endoscopic microsurgery[J]. Surgical Endoscopy . 2007 (10)

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