AIM: An ileorectal bypass performed entirely through a transanal route has recently been described in an animal model. The present study aimed study aimed to demonstrate its technical feasibility in four human cadavers. METHOD: A transanal endoscopic microsurgery (TEM) device and endoscopic instruments were used The principal steps of the procedure included insertion of the TEM device, rectostomy above the peritoneal reflection, peritoneoscopy using a standard gastroscopy, delivery of the small bowel through the proctostomy to perform an anastomosis.; RESULTS: The procedure was successfully completed using transanal access in all cases. The mean procedural time was 90 minutes. The bypass was patent and the anastomosis between the intraperitoneal rectum and the terminal ileum was leak-proof. CONCLUSION: Transanal leoproctostomy is technically feasible in human cadavers. The procedure may become an alternative in selected patients, to stoma for formation for patients with colonic obstruction.
Transanal ileoproctostomy is feasible in human cadavers
POLESE, LINO;PORZIONATO, ANDREA;MACCHI, VERONICA;STECCO, CARLA;DE CARO, RAFFAELE;NORBERTO, LORENZO;MERIGLIANO, STEFANO
2014
Abstract
AIM: An ileorectal bypass performed entirely through a transanal route has recently been described in an animal model. The present study aimed study aimed to demonstrate its technical feasibility in four human cadavers. METHOD: A transanal endoscopic microsurgery (TEM) device and endoscopic instruments were used The principal steps of the procedure included insertion of the TEM device, rectostomy above the peritoneal reflection, peritoneoscopy using a standard gastroscopy, delivery of the small bowel through the proctostomy to perform an anastomosis.; RESULTS: The procedure was successfully completed using transanal access in all cases. The mean procedural time was 90 minutes. The bypass was patent and the anastomosis between the intraperitoneal rectum and the terminal ileum was leak-proof. CONCLUSION: Transanal leoproctostomy is technically feasible in human cadavers. The procedure may become an alternative in selected patients, to stoma for formation for patients with colonic obstruction.Pubblicazioni consigliate
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