Abstract
PurposeGlove single-port laparoscopy-assisted transanal total mesorectal excision (TaTME) has been successfully carried out in our medical center. The purpose of this study is to evaluate the feasibility of this emerging operation.MethodsThis technique was performed by self-made glove single-port laparoscopic platform to radically resect low rectal cancer. Short-term postoperative results, including complications, length of hospital stay, and follow-up results were collected and analyzed statistically.ResultsThere are five consecutive patients (three males, two females) who underwent this surgery and included in this study. The mean distance from the tumor to the anal verge was 4.8 cm (range 4.0–6.0). The surgery was completed in all cases, and the rectal tumor was removed successfully without conversion; circumferential margins of all the excised specimens were negative. The mean time of operation was 338.00 min (range 280–400). The average number of lymph node dissection was 12.20. The average postoperative hospital stay was 8.60 days. During the follow-up (14.80 ± 1.92 months), all preventive ileostomies were successfully closed in about 3 months after the surgery, all patients had satisfactory anal function, and no tumor recurrence was found.ConclusionGlove single-port laparoscopy-assisted TaTME has a significant effect in specific patients with low rectal cancer, with rapid recovery and high safety. Prospective randomized studies involving more case counts and long-term follow-up results, especially oncologic outcomes, are needed to validate this technique.
Highlights
In recent decades, with the application and maturity of laparoscopy even robotics, minimally invasive surgery has developed rapidly in the field of colorectal cancer, and many new technologies have come into being
According to the transanal endoscopic platform, Transanal total mesorectal excision (TaTME) can be classified as transanal endoscopic microsurgery-TME (TEM-TME) using TEM platform and transanal minimally invasive surgery-TME (TAMISTME) using TAMIS platform
TaTME permits a clear and magnified filed to get access to the confined distal rectum from below [15]. It may reduce the difficulty of the operation and avoid some difficult situations encountered by conventional laparoscopic surgery, such as the use of stapling multiple times across the rectum, which increases the likelihood of anastomotic leak and involved distal resection margin [16]
Summary
With the application and maturity of laparoscopy even robotics, minimally invasive surgery has developed rapidly in the field of colorectal cancer, and many new technologies have come into being. The concept of natural orifice transluminal surgery (NOTES) has attracted the attention of surgeons. The “incision-free” concept of NOTES combined with the operational skills of laparoscopy shows perfect minimally invasive effect, as well as good safety and operability. Most of the reported TaTME cases were performed through traditional multi-port laparoscopic surgery (MPLS). As a developed technique, single-port laparoscopic surgery (SPLS)-assisted TaTME was reported relatively fewer, though it is becoming more and more noticeable in recent years [2,3,4]. With great interest in SPLS, we successfully performed TaTME with self-made glove single-port laparoscopic platform in our medical center. We introduce the preliminary outcomes on patients who underwent TaTME using this self-made glove single-
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