Hybrid NOTES colectomy for right-sided colonic tumors

Introduction Given the limitation of surgical access and instrumentation, pure NOTES technique currently appears challenging for colorectal surgery. As such, we would like to determine the technical feasibility and clinical results of hybrid NOTES right hemicolectomy with transrectal extraction of s...

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Bibliographic Details
Published in:Asian journal of endoscopic surgery 2012-02, Vol.5 (1), p.46-49
Main Authors: Cheung, TPP, Cheung, HYS, Ng, LWC, Chung, CCC, Li, MKW
Format: Article
Language:English
Subjects:
Adenocarcinoma - surgery
Adult
Colectomy - methods
Colonic Neoplasms - surgery
Colonic surgery
Female
Humans
hybrid NOTES
laparoscopic surgery
Natural Orifice Endoscopic Surgery - methods
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Summary:Introduction Given the limitation of surgical access and instrumentation, pure NOTES technique currently appears challenging for colorectal surgery. As such, we would like to determine the technical feasibility and clinical results of hybrid NOTES right hemicolectomy with transrectal extraction of specimen. Materials and Surgical Technique After the right‐sided colon was fully mobilized and vessels ligated, bowel resection and intracorporeal side‐to‐side ileocolic anastomosis were performed with endostaplers. The Transanal Endoscopic Operations device was inserted transanally. The resected specimen was removed via the Transanal Endoscopic Operations device through an enterotomy made over the anterior wall of the upper rectum. Discussion The operation was performed on a 42‐year‐old woman and lasted 120 minutes; blood loss was 30 mL. The patient had an uneventful recovery and was discharged on postoperative day 5. The median pain score was 2 (range, 2–3). Our preliminary experience shows that hybrid NOTES right hemicolectomy is safe and feasible. The technique eliminates the need for mini‐laparotomy in patients undergoing laparoscopic right hemicolectomy, and it offers promise in this era of minimally invasive surgery.
ISSN:1758-5902
1758-5910
DOI:10.1111/j.1758-5910.2011.00106.x