Infections

All Conditions

Symptoms and General Pathology

Wounds and Injuries

Communicable Diseases

Surgical Wound Infection

Hernia

Surgical Wound

Incisional Hernia

Pathological Conditions, Anatomical

Postoperative Complications

Herbal and Botanical

All Drugs and Chemicals

Cola

Ersin Gundogan, MD

In the development of surgical technique, laparoscopic surgery has created a major breaking point. Although laparoscopy (decreased hospital stay, decreased incisional hernia and wound infection rate...) provides a remarkable advantage compared to open surgery, the need for the extraction site incision could not bring the incision-related morbidity rates to the desired level. That's why SILS and natural hole surgery came to the fore. Colorectal surgery was also affected by this process, and the laparoscopic colectomy procedure combined with transrectal colon extraction was first performed in 1993 (1). Although its use increased gradually after this period, it could not reach the expected levels and this could not resolve the concerns on natural hole surgery.

In this article, our aim is to present the single center results of the patients who performed the extraction with the NOSE method after laparoscopic colorectal surgery.

Total 102 Natural Orifice Specimen Extractions Following Laparoscopic Colorectal Resections

Hernia, infection, hospital stay and aesthetic score

Inonu University

Doctor- lecturer-Principal Investigator

Neoplasms

Digestive System Diseases

Colorectal Neoplasms

Intestinal Neoplasms

Gastrointestinal Neoplasms

Digestive System Neoplasms

Gastrointestinal Diseases

Colonic Diseases

Intestinal Diseases

Rectal Diseases

Conventional laparoscopic resection of colorectal cancer with natural orifice specimen extraction

Laparoscopic assisted transanal endoscopic resection of rectal cancer

Conventional laparoscopic resection of colorectal cancer is done then specimen is extracted through natural orifice (anal or vaginal orifice).

natural orifice specimen extraction

Endoscopic phase: Transanal platform is inserted into the rectum, and pneumorectum is established. The lumen is occluded below the level of the tumor. The avascular ''oncologic'' presacral plane is entered posteriorly, and dissection proceeds cephalad in the total mesorectal excision planes. Next, the abdominal cavity is entered at the peritoneal reﬂection. The superior rectal artery is divided. The rectal stump then is reﬂected into the abdominal cavity, and retrograde dissection is performed until the procedure is limited by instrument length.

Laparoscopic phase: Colon mobilization, lymph node dissection, and mesenteric excision are performed laparoscopically. Mobilization of the splenic ﬂexure is done if needed.

Laparoendoscopic resection

Islam H Metwally, M.Sc

Mohamed A Hegazy, MD

Waleed E Rashad, MD

Jose F Noguira, MD

Sherif Z Kotb, MD

The purpose of this study is to assess different hybrid natural orifice transluminal endoscopic surgery techniques in management of colorectal cancer as regard: feasibility of the technique, short term oncologic outcome and functional outcome.

Intervention will be done by conventional laparoscopy and transanal endoscopy (TEO or Gelpoint platform), patients are divided into two arms to compare different natural orifice techniques in resection of colorectal cancer.

Natural Orifice Transluminal Endoscopic Surgery for Colorectal Cancer

Rate of conversion to classic laparoscopy or to open laparotomy.

time taken from starting operation till patient wake up

It is a composite outcome where result will appear as either complete, near complete or incomplete. Criteria in (shape, coning, presence of defects and circumferential safety margin) will be integrated to categorize it.

either free or infiltrated with tumor by histopathology examination.

incidence of local and distant outcomes and disease free survival

assessing fecal incontinence using Kirwan's grading score

Study title	NCT ID	Conditions	Interventions	Eligibility	Organization	Link
Total 102 Natural Orifice Specimen Extractions Following Laparoscopic Colorectal Resections	NCT04394988	Incisional Hern... Incision Infect...		-	Inonu University
Natural Orifice Transluminal Endoscopic Surgery for Colorectal Cancer	NCT02549456	Colorectal Canc...	natural orifice... Laparoendoscopi...	-	Mansoura University

Spots Global Cancer Trial Database for natural orifice surgery