Subject(s)
Humans , History, 19th Century , History, 20th Century , History, 21st Century , Surgical Equipment/history , Natural Orifice Endoscopic Surgery/history , Robotic Surgical Procedures/trends , Transanal Endoscopic Surgery/history , Transanal Endoscopic Microsurgery/history , Colorectal Surgery/history , Natural Orifice Endoscopic Surgery/methods , Transanal Endoscopic Surgery/instrumentation , Transanal Endoscopic Surgery/methods , Transanal Endoscopic Microsurgery/methodsSubject(s)
Humans , Rectal Neoplasms/surgery , Natural Orifice Endoscopic Surgery/methods , Transanal Endoscopic Surgery/methods , Proctectomy/instrumentation , Proctectomy/methods , Preoperative Care , Treatment Outcome , Patient Positioning , Natural Orifice Endoscopic Surgery/instrumentation , Operative Time , Transanal Endoscopic Surgery/instrumentationABSTRACT
La morbilidad y alteración de la calidad de vida asociadas a la resección anterior del recto y amputación abdominoperineal determinaron un gran interés en el desarrollo del abordaje transanal. En los últimos años se ha visto un marcado desarrollo tecnológico en los dispositivos disponible para este abordaje. La cirugía por vía transanal ofrece ventajas en cuanto a sus resultados y complicaciones cuando se la compara a la cirugía por vía abdominal. La cirugía transanal mini-invasiva surge como una alternativa de abordaje videoendoscópico del recto. La resección local por cirugía endoscópica para los pólipos grandes de recto se ha convertido en un nuevo estándar de tratamiento en la mayoría de los centros, obteniendo piezas no fragmentadas con una alta tasa de márgenes negativos. En el presente estudio realizamos una revisión sobre la aplicación de TAMIS (TransAnal Minimally Invasive Surgery) al tratamiento de los pólipos de recto. (AU)
A great interest has developed in implementing trans anal minimally invasive surgery for the treatment of rectal adenomas and early rectal tumors. It present advantages when compare to radical surgery and peace meal endoscopic resections. TAMIS delivers non-fragmented specimens with clear resection margin in the majority of the cases. Such good technical results are mirrored with a low recurrence rate when evaluating rectal adenomas. This is a review of the application of TAMIS for the treatment of rectal adenomas. (AU)
Subject(s)
Humans , Middle Aged , Rectum/surgery , Intestinal Polyps/surgery , Intestinal Polyps/epidemiology , Transanal Endoscopic Surgery/instrumentation , Transanal Endoscopic Surgery/methods , Postoperative Complications , Quality of Life , Rectal Neoplasms/surgery , Rectal Neoplasms/epidemiology , Morbidity , Treatment Outcome , Survivors , Fecal Incontinence/epidemiologyABSTRACT
ABSTRACT Purpose: Vesicorectal fistula is one of the most devastating postoperative complications after radical prostatectomy. Definitive treatment is difficult due to morbidity and recurrence. Despite many options, there is not an unanimous accepted approach. This article aimed to report a new minimally invasive approach as an option to reconstructive surgery. Materials and Methods: We report on Transanal Minimally Invasive Surgery (TAMIS) with miniLap devices for instrumentation in a 65 year old patient presenting with vesicorectal fistula after radical prostatectomy. We used Alexis® device for transanal access and 3, 5 and 11 mm triangulated ports for the procedure. The surgical steps were as follows: cystoscopy and implant of guide wire through fistula; patient at jack-knife position; transanal access; Identification of the fistula; dissection; vesical wall closure; injection of fibrin glue in defect; rectal wall closure. Results: The operative time was 240 minutes, with 120 minutes for reconstruction. No perioperative complications or conversion were observed. Hospital stay was two days and catheters were removed at four weeks. No recurrence was observed. Conclusions: This approach has low morbidity and is feasible. The main difficulties consisted in maintaining luminal dilation, instrumental manipulation and suturing.