Optimal Dissection for Transanal Total Mesorectal Excision Using Modified CO2 Insufflation and Smoke Extraction

Overview

Journal Colorectal Dis

Specialty Gastroenterology

Date 2015 Jul 29

PMID 26218459

Citations 21

Authors

G Nicholson

J Knol

B Houben

C Cunningham

S Ashraf

R Hompes

Affiliations

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Abstract

Aim: The new approach of transanal total mesorectal excision is technically challenging and demands a stable field of dissection with optimal view of anatomical landmarks. We aimed to describe and demonstrate a modification of both the insufflation of carbon dioxide and smoke evacuation, in order to optimize dissection.

Method: The comparison of standard insufflation to an AirSeal platform demonstrates a clear difference. This is shown in the accompanying video-recordings.

Results: A more stable pneumorectum and better smoke evacuation as well as more convenient and precise dissection were achieved with the AirSeal platform.

Conclusion: Using the technique outlined, the operating surgeon is able to perform the surgical dissection in a stable operating environment with increased visibility compared to the standard approach.

Citing Articles

Comparison of laparoscopic partial nephrectomy performed with AirSeal® system vs. standard insufflator: results from a referral center.

Forte F, Tripodi D, Pironi D, Corongiu E, Gagliardi F, Frisenda M Front Surg. 2023; 10:1220332.

PMID: 37440928 PMC: 10335758. DOI: 10.3389/fsurg.2023.1220332.

The Usefulness of AirSeal™ Intelligent Flow System in Gas Insufflation Total Endoscopic Thyroidectomy.

Katoh H, Ikeda Y, Saito Y, Yokota M, Kikuchi M, Sengoku N Indian J Otolaryngol Head Neck Surg. 2023; 75(1):115-120.

PMID: 37007898 PMC: 10050613. DOI: 10.1007/s12070-022-03257-0.

Evolution of transanal total mesorectal excision according to the IDEAL framework.

Roodbeen S, Lo Conte A, Hirst A, Penna M, Bemelman W, Tanis P BMJ Surg Interv Health Technol. 2022; 1(1):e000004.

PMID: 35047772 PMC: 8749305. DOI: 10.1136/bmjsit-2019-000004.

Carbon dioxide gas leaks during transanal minimally invasive surgery.

Khan M, Cahill R Tech Coloproctol. 2020; 24(12):1307-1308.

PMID: 32638139 PMC: 7339795. DOI: 10.1007/s10151-020-02284-9.

Using taTME to maintain restorative options in locally advanced rectal cancer: A technical note.

Larach J, Waters P, McCormick J, Heriot A, Smart P, Warrier S Int J Surg Case Rep. 2020; 73:39-43.

PMID: 32629220 PMC: 7338998. DOI: 10.1016/j.ijscr.2020.06.015.