| Abstract: |
Aim: Minimally invasive surgery is advancing with single port access (SPA). We describe a technique for a SPA transabdominal combined with transanal approach to perform laparoscopic proctectomy with total mesorectal excision (TME) and intersphincteric resection of low rectal adenocarcinoma. Method: Transanal intersphincteric resection was followed by laparoscopic abdominal proctectomy with TME. An SPA device was placed at the site of the future stoma through a 2.5-cm incision. A hand-sewn side-to-end coloanal anastomosis was performed and a terminal loop ileostomy was created at the site of the SPA device. Results: The procedure was performed on two healthy nonobese women who had not had previous abdominal surgery. The operating times were 195 and 210min, and blood loss <250ml. The postoperative course was uneventful, with discharge on postoperative days 5 and 6. Pathological examination revealed adequate surgical margins and lymph node retrieval with an intact mesorectum. Four weeks after stoma closure, the scar in the right lower quadrant was 35mm in one patient and 45mm in the other, and the scar from the 5-mm port was barely visible. Conclusion: This preliminary experience shows that proctectomy with TME and intersphincteric resection can be safely performed using only two ports. © 2011 The Authors Colorectal Disease © 2011 The Association of Coloproctology of Great Britain and Ireland. |
