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Transanal total mesorectal excision (TaTME) using flexible endoscope with laparoscopic assistance: a pilot study in porcine models.

Authors :
Sun T
Cao Z
Zhang Y
Li B
Huang Y
Zou G
Yin X
Yuan X
Zhang C
Ning S
Source :
Updates in surgery [Updates Surg] 2020 Sep; Vol. 72 (3), pp. 845-850. Date of Electronic Publication: 2020 May 12.
Publication Year :
2020

Abstract

Background: Transanal total mesorectal excision (TaTME) is routinely performed to excise low rectal tumors. TaTME often relies on transanal endoscopic microsurgery (TEM) or transanal minimally invasive surgery (TAMIS) platform, all using rigid endoscopes. Our study reported a novel approach to TaTME which was completed using flexible endoscope, and we named it F-TaTME.<br />Methods: The feasibility of rectum resection using F-TaTME was evaluated in five pigs. Firstly, the superior rectal artery and vein were managed under the assistance of laparoscopy. Secondly, the flexible endoscope was used to complete the full-thickness rectotomy and rectal mobilization. Finally, the specimen was removed and the manual colon-rectal anastomosis was performed under direct vision.<br />Results: F-TaTME was accomplished in all 5 pigs. The mean procedure time was 136.6 min (97-162 min). The mean length from the lower edge of the lesion to circumferential dissection line was 1.4 cm (1.0-1.8 cm) and mean length of exteriorized rectum was 12.6 cm (11-14 cm). No injury to colorectal wall, adjacent pelvic or abdominal organs was found.<br />Conclusions: Our preliminary data suggested that F-TaTME may be a feasible method for TaTME.

Details

Language :
English
ISSN :
2038-3312
Volume :
72
Issue :
3
Database :
MEDLINE
Journal :
Updates in surgery
Publication Type :
Academic Journal
Accession number :
32399596
Full Text :
https://doi.org/10.1007/s13304-020-00768-9