MA-NOS Radical Sigmoidectomy: Report of a Transvaginal Resection in the Human

Overview

Journal Surg Endosc

Publisher Springer

Specialties Gastroenterology
General Surgery
Radiology

Date 2008 May 8

PMID 18461385

Citations 64

Authors

Antonio M Lacy

Salvadora Delgado

Oscar A Rojas

Raul Almenara

Anabel Blasi

Josep Llach

Affiliations

Soon will be listed here.

Abstract

Background: With available laparoscopic and endoscopic instruments/technology a standard radical sigmoid resection is feasible and safe using transvaginal minilaparoscopic-assisted natural orifice surgery (MA-NOS).

Methods: The intervention was a transvaginal MA-NOS sigmoidectomy in a 78-year-old woman with a sigmoid adenocarcinoma. Maintaining triangulation the surgeon positioned himself at the right side of the patient and used the transvaginal trocar for dissection and stapling of both the inferior mesenteric vessels and the upper rectum. The colonic resection was performed extracorporeally in the conventional fashion and was followed by an intra-abdominal endoscopically assisted stapled anastomosis.

Results: Advantages of minimally invasive surgery seemed to be enhanced with this hybrid laparoscopic approach. Postoperative course was uneventful. All oncological principles governing resection and management were accomplished and the pathology examination confirmed a T3N1 lesion. The patient was discharged on the fourth postoperative day.

Conclusion: Transvaginal MA-NOS radical sigmoidectomy is a feasible and oncologically safe procedure. MA-NOS is a realistic option for avoiding the need of assisting incisions and related morbidity in the laparoscopic resection of large intra-abdominal lesions. Combined hybrid laparoscopic NOS in humans (MA-NOS) currently provides a safe and reliable way of defining future clinical applications and advantages of NOS and NOTES. Additionally, it stimulates the active development and evaluation of the underpinning technologies and instrumentation.

Citing Articles

Retrospective analysis of immediate and long-term results of NOSES technique and conventional laparoscopic-assisted resection in patients with colorectal cancer.

Malev S, Zhang H, Yuan Z, Tang Q, Wang G, Oganezov G Front Surg. 2024; 11:1444942.

PMID: 39364371 PMC: 11446899. DOI: 10.3389/fsurg.2024.1444942.

Feasibility and safety of hybrid transvaginal natural orifice transluminal endoscopic surgery for colon cancer: Protocol for a multicenter, single-arm, phase II trial (vNOTESCA).

Fu T, Ren J, Yao H, Huang B, Sun L, Li X Heliyon. 2023; 9(10):e20187.

PMID: 37780770 PMC: 10539939. DOI: 10.1016/j.heliyon.2023.e20187.

Evolution of Transanal Total Mesorectal Excision.

Carmichael H, Sylla P Clin Colon Rectal Surg. 2020; 33(3):113-127.

PMID: 32351334 PMC: 7188508. DOI: 10.1055/s-0039-3402773.

Evolution of transanal total mesorectal excision for rectal cancer: From top to bottom.

Emile S, de Lacy F, Keller D, Martin-Perez B, Alrawi S, Lacy A World J Gastrointest Surg. 2018; 10(3):28-39.

PMID: 29588809 PMC: 5867456. DOI: 10.4240/wjgs.v10.i3.28.

Re-appraisal and consideration of minimally invasive surgery in colorectal cancer.

Abu Gazala M, Wexner S Gastroenterol Rep (Oxf). 2017; 5(1):1-10.

PMID: 28567286 PMC: 5444240. DOI: 10.1093/gastro/gox001.

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