Techniques for the extraction of high rectal foreign bodies by transanal minimally invasive surgery

Removal of rectosigmoid retained foreign bodies (RFB) may require laparoscopy and often laparotomy. Proctoscopic extraction from the distal sigmoid colon and proximal rectum can be technically difficult. Using a transanal minimally invasive surgery (TAMIS) approach, RFBs can be safely removed, avoid...

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Bibliographic Details
Published in:Techniques in coloproctology 2021-03, Vol.25 (3), p.339-342
Main Authors: Zhao, B., Roper, M. T., Tomassi, M. J., Wenger, S. J., Klaristenfeld, D.
Format: Article
Language:English
Subjects:
Abdominal Surgery
Anal Canal - surgery
Colorectal Surgery
Foreign bodies
Foreign Bodies - surgery
Gastroenterology
Humans
Laparoscopy
Laparotomy
Medicine
Medicine & Public Health
Minimally invasive surgery
Minimally Invasive Surgical Procedures
Proctology
Rectal Neoplasms - surgery
Rectum - surgery
Surgery
Surgical outcomes
Technical Note
Transanal Endoscopic Surgery
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Summary:Removal of rectosigmoid retained foreign bodies (RFB) may require laparoscopy and often laparotomy. Proctoscopic extraction from the distal sigmoid colon and proximal rectum can be technically difficult. Using a transanal minimally invasive surgery (TAMIS) approach, RFBs can be safely removed, avoiding an abdominal operation with associated morbidity. Patients without clinical findings concerning for acute colonic perforation undergo bedside digital rectal examination and proctoscopic attempt at removal of RFB. If unsuccessful, patients undergo rectal examination under anesthesia with proctoscopy and attempted RFB removal. If the RFB cannot be easily removed, a TAMIS port is inserted into the anal canal and pneumorectum is established. A laparoscopic camera and instruments are then used to facilitate removal of the RFB. To date, TAMIS was successful in all 10 patients with RFB requiring an operation. All patients tolerated the procedure well and were discharged to home from the postoperative recovery room. Unfortunately, none of the patients presented for follow-up visits, but there were no known complications. This technique can be considered prior to laparotomy for patients with RFBs after failed digital examination with proctoscopy.
ISSN:1123-6337
1128-045X
DOI:10.1007/s10151-020-02396-2