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Volume 6, Issue 8(Suppl) J Gastrointest Dig Syst 2016
ISSN:2161-069X JGDS, an open access journal
Page 23
Notes:
Digestive Diseases 2016
December 08-09, 2016
conferenceseries.com
Digestive Diseases
December 08-09, 2016 Dubai, UAE
International Conference on
Laparoscopic anterior resection with Natural Orifice Specimen Extraction (NOSE) for rectal cancer
Muhammad S Niam
Brawijaya University, Indonesia
Laparoscopic colorectal cancer resection requires another abdominal incision to extract the resected specimen. We describe a
technique for laparoscopic resection of an upper rectal cancer in a 50-year-old man followed by transanal specimen delivery,
hence avoiding the need for making any additional abdominal incisions for retrieval of the specimen. Pneumoperitoneum was
created, followed by medial-to-lateral mobilization of the sigmoid colon and take down of the splenic flexure and division of the
inferior mesenteric vessels laparoscopically. The rectum distal to the tumor was tightly bounded extra-luminally by gauze tape and
transected after distal intraluminal irrigation through anal opening under direct vision by transanal rigid endoscopy. The proximal
stump was extracted transanally via an opening in the rectal stump. The proximal colon was then transected extra-corporeally and
the anvil of the circular stapler inserted before returning it to the pelvic cavity. The distal rectal stump was circularly sutured and
the colorectal anastomosis was then completed intracorporeally. The patient with an annular rectal cancer 10cm from the anal verge
underwent that procedure. Postoperative recovery was uneventful. He has resumed normal daily activities 1 week after surgery.
Histopatology confirmed a moderately differentiated T3N0 upper rectal adenocarcinoma. In the effort to minimize surgical trauma
and postoperative pain, natural orifice specimen extraction techniques have been attempted. This procedure may be applicable to
benign tumors and early colorectal cancer and serves as an intermediate step between laparoscopic and natural orifice endoscopic
surgery.
Biography
Muhammad S Niam is a General Surgeon, a Consultant in Digestive Surgery and also an Endoscopic and Laparoscopic Surgeon. He is a Lecturer and Medical Staff of
Saiful Anwar General Hospital/Brawijaya University School of Medicine, Malang, Indonesia. He is a Chairman of Indonesian Society of General Surgery of Malang Region,
National Faculty Member of Indonesian Society of Endo-laparoscopic Surgery, National Faculty Member of Indonesian Society of Coloproctology and Committee of Asian
Society of Colorectal Surgery.
Muhammad S Niam, J Gastrointest Dig Syst 2016, 6:8(Suppl)