A simple transanal technique to complete perineal dissection of a proctectomy when the limits are not visible from above or below.

Abstract

BACKGROUND An intersphincteric dissection is often used in a proctectomy for benign pathology such as ulcerative colitis, thereby avoiding a large perineal defect. The narrow confines of this approach can make the dissection technically challenging, especially when compounded by body habitus or a narrow pelvis. Transanal minimally invasive surgery (TAMIS) has been developed for both local and extensive resections involving the low and midrectum, usually requiring a single incision laparoscopic surgery port and development of skills to perform extensive transanal resection. A transanal approach using simple theatre equipment to create a single glove port has been reported but is seldom used as an option in difficult cases.