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Transanal endoscopic operation

Mario Guerrieri, Monica Ortenzi, Giovanni Lezoche, Stefano Mancini, Roberto Ghiselli
BACKGROUND: Transanal endoscopic microsurgery (TEM) is a minimally invasive technique allowing to excise large rectal adenomas by local approach. This study shows the feasibility and results of a long term experience of TEM applied in this field. METHODS: A retrospective investigation was performed in patients affected by rectal adenomas (5-11 cm in diameter) who had undergone transanal endoscopic microsurgery from 1992 to 2015. A series of 207 patients met the inclusion criteria and were analyzed for characteristics, intraoperative and postoperative results and long-term follow-up...
December 2016: Minerva Chirurgica
Alyson A Melin, Sudhir Kalaskar, Lindsay Taylor, Jon S Thompson, Charles Ternent, Sean J Langenfeld
BACKGROUND: Transanal endoscopic microsurgery (TEM) and transanal minimally invasive surgery (TAMIS) have been shown to improve the quality of transanal resections, allowing for improved visibility and access to the proximal rectum. This study compares the short-term outcomes between TEM and TAMIS among experienced colorectal surgeons. METHOD: A retrospective review was conducted for TEM and TAMIS performed from 2012 to 2015 by local colorectal surgeons. Baseline patient demographics, operative variables, pathology results, and short-term outcomes were assessed...
September 28, 2016: American Journal of Surgery
Jae Hwan Oh, Sung Chan Park, Min Jung Kim, Byung Kwan Park, Jong Hee Hyun, Hee Jin Chang, Kyung Su Han, Dae Kyung Sohn
PURPOSE: To evaluate the feasibility of transanal total mesorectal excision (TME) in patients with rectal cancer. METHODS: This study enrolled 12 patients with clinically node negative rectal cancer located 4-12 cm from the anal verge who underwent transanal endoscopic TME with the assistance of single port laparoscopic surgery between September 2013 and August 2014. The primary endpoint was TME quality; secondary endpoints included number of harvested lymph nodes and postoperative complications within 30 days (NCT01938027)...
October 2016: Annals of Surgical Treatment and Research
Kiryu Yap, Sarah Mills, Michelle Thomas, James Moore
BACKGROUND: To establish the incidence of unsuspected malignancy in lesions excised through transanal endoscopic microsurgery (TEM) and examine the justification for full-thickness excision of all lesions thought to be benign pre-operatively. METHODS: Demographic, operative and pathology data of all patients undergoing TEM at a single institution were collected in a prospectively maintained database. Follow-up data were collected with a focus on polyp recurrence rates and outcome in patients found to harbour malignancy...
October 9, 2016: ANZ Journal of Surgery
Giancarlo D'Ambrosio, Gianfrancesco Intini, Andrea Balla, Silvia Quaresima, Andrea Picchetto, Ardit Seitaj, Salvatore Campo, Francesca De Laurentis, Alessandro M Paganin
AIM: Recto-Urinary Fistula (RUF) is a rare complication of pelvic surgery. Different approaches are reported in literature but a gold standard treatment has not yet been achieved. Transanal Endoscopic Microsurgery (TEM) is a miniinvasive approach with well known advantages as magnification, 3D view and lighting of the operative field. Aim of the present review is to report the current evidence in literature about technique and results of RUF treatment by TEM and to suggest some key points for its correct management...
2016: Annali Italiani di Chirurgia
Monica Ortenzi, Roberto Ghiselli, Maria Michela Cappelletti Trombettoni, Luca Cardinali, Mario Guerrieri
AIM: To analyze the outcomes of transanal endoscopic microsurgery (TEM) in the treatment of rare rectal condition like mesenchymal tumors, condylomas, endometriosis and melanoma. METHODS: We retrospectively reviewed a twenty-three years database. Fifty-two patients were enrolled in this study. The lesions were considered suitable for TEM if they were within 20 cm from the anus. All of them underwent an accurate preoperative workup consisting in clinical examination, total colonoscopy with biopsies, endoscopic ultrasonography, and pelvic computerized tomography or pelvic magnetic resonance imaging...
September 16, 2016: World Journal of Gastrointestinal Endoscopy
Balázs Bánky, Géza Járay
Diseases of the lower and middle third of the rectum, the so called "no-man's territory" traditionally represent a major surgical problem. Minimally invasive surgical techniques significantly contribute to the safe and precise management of this part of the rectum. Traditional laparoscopic instruments via a specifically designed operative anoscope with single-port surgical technique are used during TAMIS (transanal endoscopic minimally invasive surgery). Since the description of the procedure in 2009 a number of case series have proven the feasibility and safety of the technique in the treatment of rectal adenomas...
September 2016: Magyar Sebészet
Constantinos Nastos, Ira Sotirova, Athanasios Papatsoris, Andreas Skolarikos, Ioannis Papaconstantinou, Athanasios Dellis
BACKGROUND: Urethrorectal fistula is a rare and debilitating condition. Spontaneous closure is rarely effective, and appropriate management regarding timing of repair and surgical approach remains controversial. CASE PRESENTATION: We present a case of an 18-year-old male found to have a urethrorectal fistula after diagnostic work up for unejaculation. The patient gradually developed recurrent urinary tract infections and urine and semen leak from his rectum. He had a medical history of an anorectal reconstruction in the second postnatal day due to an anorectal malformation...
2016: Journal of Endourology Case Reports
Silvia Quaresima, Andrea Balla, Luana Franceschilli, Marco La Torre, Corrado Iafrate, Mostafa Shalaby, Nicola Di Lorenzo, Pierpaolo Sileri
BACKGROUND AND OBJECTIVES: Transanal minimally invasive surgery (TAMIS) has emerged as an alternative to transanal endoscopic microsurgery (TEM). The authors report their experience with TAMIS for the treatment of mid and high rectal tumors. METHODS: From November 2011 through May 2016, 31 patients (21 females, 68%), with a median age of 65 years who underwent single-port TAMIS were prospectively enrolled. Mean distance from the anal verge of the rectal tumors was 9...
July 2016: JSLS: Journal of the Society of Laparoendoscopic Surgeons
Carl Brown, Manoj J Raval, P Terry Phang, Ahmer A Karimuddin
BACKGROUND: To determine whether closure of the defect created during full thickness excision of a rectal lesion with transanal endoscopic microsurgery (TEM) leads to fewer complications when compared to leaving the defect unsutured. METHODS: This is a single-center cohort study using a prospectively maintained database. All patients ≥18 years old treated with full thickness TEM with no compromise of the peritoneal cavity were included. Two cohorts were established: patients with the defect sutured and patients with the defect left open...
July 7, 2016: Surgical Endoscopy
Ezra N Teitelbaum, Fahd O Arafat, Anne-Marie Boller
BACKGROUND: Transanal endoscopic surgery (TES) can be technically difficult due to the constraints of operating through a narrow proctoscope channel. In this study, we compared the performance of surgical novices using instruments with and without articulating shafts to perform a simulated TES task. METHODS: Medical students each performed 10 repetitions of the Fundamentals of Laparoscopic Surgery circle-cut task. Participants were randomized into 3 groups: 2 performed the task through a TES proctoscope using scissors with either a rigid (TES-R) or articulating (TES-A) shaft...
August 2016: Surgical Laparoscopy, Endoscopy & Percutaneous Techniques
Shingo Noura, Masayuki Ohue, Norikatsu Miyoshi, Masayoshi Yasui
Transanal endoscopic microsurgery (TEM) is a minimally invasive technique. However, TEM has not yet achieved widespread use. Recently, transanal minimally invasive surgery (TAMIS) using single-port surgery devices has been reported. In the present study, TAMIS using a GelPOINT(®) Path was performed in six patients with lower rectal cancer. A complete full-thickness excision was performed in all cases. The patient characteristics, operative techniques and operative outcomes were evaluated. The mean age of the patients was 63...
July 2016: Molecular and Clinical Oncology
Fei-Hu Yan, Zheng Lou, Shi-Jie Hu, Xiao-Dong Xu, Hao Wang, Han-Tao Wang, Rong-Gui Meng, Chuan-Gang Fu, Wei Zhang, Jian He, En-da Yu
AIM: The aim of this study is to compare the short-term clinical outcomes between endoscopic submucosal dissection and transanal local excision for rectal carcinoid tumors. METHODS: Between 2007 and 2012, 31 patients with rectal carcinoid underwent endoscopic submucosal dissection at our hospital. They were compared with a matched cohort of 23 patients who underwent transanal local excision for rectal carcinoid between 2007 and 2012. Short-term clinical outcomes including surgical parameters, postoperative recovery, and oncologic outcomes were compared between the two groups...
2016: World Journal of Surgical Oncology
José Joaquim Ribeiro da Rocha, Mário Vinícius Angelete Alvarez Bernardes, Marley Ribeiro Feitosa, Camila Perazzoli, Vanessa Foresto Machado, Fernanda Maris Peria, Harley Francisco de Oliveira, Omar Feres
PURPOSE: In this paper we report the oncological outcomes from clinical series of patients with rectal cancer submitted to local excision after neoadjuvant therapy and discuss the indications for local excision in partial clinical responders. METHODS: We analysed a prospective database of 39 patients submitted to a transanal endoscopic operation for rectal cancer after neoadjuvant chemoradiation between 2006 and 2015, comparing clinical and pathological variables, perioperative complications, recurrence rate and overall survival...
2016: Acta Cirúrgica Brasileira
F Dumont, E Thibaudeau, L Benhaïm, S Gouy, D Labbe, C Honoré, D Goéré
BACKGROUND: The extraperitoneal rectal dissection via a transanal approach facilitates the mesorectal dissection. The retroperitoneal approach for mesocolic excision may also offer some similar advantages. To complete the lymphadenectomy of extraperitoneal mesorectal resection, we developed an innovative approach for upper rectal and mesocolic excision via an exclusive retroperitoneal dissection using a single-port access at the site of the future stomy. METHODS: This study was a prospective pilot study and was conducted between 2013 and 2015 at two oncologic centers...
May 3, 2016: Surgical Endoscopy
Hyuk Hur, Sung Uk Bae, Yoon Dae Han, Jeonghyun Kang, Byung Soh Min, Seung Hyuk Baik, Kang Young Lee, Nam Kyu Kim
PURPOSE: We aim to report outcomes and learning curve of transanal endoscopic operation (TEO) for rectal tumors, using standard laparoscopic instruments under a magnifying laparoscopic monitor view. MATERIALS AND METHODS: From January 2012 to July 2014, local excision was performed using a TEO system in 46 consecutive patients with rectal tumors. Patient and tumor characteristics and perioperative outcomes were prospectively assessed. RESULTS: The median patient age was 56 years for 15 women and 31 men...
June 2016: Surgical Laparoscopy, Endoscopy & Percutaneous Techniques
Calogero Cipolla, Giuseppina Ferro, Giuseppa Graceffa, Lorenzo Morini, Giuseppina Guercio, Salvatore Vieni, Gianni Pantuso
UNLABELLED: represents a safe and complete technique to remove benign lesions of the rectum not treatable by endoscopy and malignant rectal lesions at early stage. It is a valid alternative to transanal endoscopic microsurgery (TEM), to conventional transanal surgery and to transabdominal resection. METHODS: In our operating Unit we performed a resection of 8 voluminous adenoma in the rectal ampulla with SILSTM-Port. RESULTS: The mean age of the patients was of 51...
2016: Annali Italiani di Chirurgia
Khalid A Osman, Daniel Ryan, Sorena Afshar, Zakir K Mohamed, Dharmendra Garg, Talvinder Gill
Transanal endoscopic microsurgery (TEM) is a minimally invasive technique that is increasingly being used to treat early rectal cancer (T1/T2). We studied the outcomes of TEM for rectal cancer at our institution looking at the indication, recurrence rate, need for further radical surgery, 30-day and 12-month mortality and complication rate. We performed a retrospective analysis of prospectively collected data of cases between 2008 and 2012: 110 TEM procedures were performed during this period: 40 were confirmed rectal cancers and 70 were benign...
December 2015: Indian Journal of Surgery
Reem Khoury, Simon D Duek, Nidal Issa, Wisam Khoury
INTRODUCTION: Local excision is the treatment of choice for large benign rectal lesions. Transanal endoscopic microsurgery is recommended. The excision of large lesions >4 cm has been previously described. We report our series of lesions >5 cm that have been excised via the transanal endoscopic microsurgery. METHODS: Patients who underwent transanal endoscopic microsurgery for rectal tumors, between the years 2002-2012, were identified. Patients with tumors greater than 5 cm consisted the study group...
May 2016: International Journal of Surgery
E Chouillard, A Regnier, R-L Vitte, B V Bonnet, V Greco, E Chahine, R Daher, J Biagini
BACKGROUND: Natural orifice transluminal endoscopic surgery (NOTES) and single-incision laparoscopy are spreading worldwide. Total mesorectal excision (TME), the standard treatment for patients with distal rectal tumors, is usually performed in an "up-to-down" approach, either laparoscopically (LAPTME) or as an open procedure. We have already reported a NOTES-inspired, transanal, "down-to-up" variant of TME (NOTESTME). The main aim of this study was to assess the quality of the resected specimen in patients who had undergone either NOTESTME or LAPTME...
August 2016: Techniques in Coloproctology
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