Transanal minimally invasive surgery for total mesorectal excision (ETM) through transanal approach (TaETM) with robotic and Transanal Endoscopic Operations (TEO) combined access: step by step surgery

ABCD. Arquivos Brasileiros de Cirurgia Digestiva (São Paulo)

Carlos Ramon Silveira Mendes¹  Marcus ValadÃo¹  Rodrigo AraÚjo¹  Eduardo Linhares¹  José Paulo Jesus¹ 

关键词: Surgical procedures;    Minimally invasive;    Robotics;    Natural orifice endoscopic surgery;    Surgical procedures;    Operative;    Procedimentos cirúrgicos minimamente invasivos;    Robótica;    Cirurgia endoscópica por orifício natural;    Procedimentos cirúrgicos operatórios;   

DOI  :  10.1590/S0102-67202015000200008

来源: SciELO

【 摘 要 】

RATIONAL: In the treatment of colorectal cancer, from 1982 Heald proposed standardization of the total mesorectal excision, with a significant reduction in the recurrence rate. But the treatment of lower rectal lesions is still a challenge. AIM: To describe the association of robotic low anterior resection- TATA (Transanal Abdominal Transanal Resection), with transanal access using Transanal Endoscopic Operations - TEO in the treatment of lower rectal cancer. METHOD: The TATA performs robotic abdominal approach and the TEO performs the perineal approach, developing total mesorectal excision (TME) transanally (TaETM). RESULT: The TaETM technique was applied in a woman with rectal adenocarcinoma 5 cm from the anal verge that had been submitted to chemoradiation. The procedure was performed with satisfatory operative time and favorable oncological outcome (grade 3 mesorectal excision). CONCLUSION: This is a promising minimally invasive procedure in the armamentarium of rectal cancer treatment, specially in challenging scenarios such as narrow pelvis, obesity and very low rectal tumors.

【 授权许可】

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