Single Port Transanal Surgery of a Giant Rectal Adenoma
RenéE M. Barendse*1, Pascal G. Doornebosch2, Willem a. Bemelman3, Evelien Dekker1, Paul Fockens1, Thomas M. Van Gulik3, Eelco J. De Graaf2
1Gastroenterology and Hepatology, Academic Medical Center, Amsterdam, Netherlands; 2Surgery, IJsselland Hospital, Capelle aan den IJssel, Netherlands; 3Surgery, Academic Medical Center, Amsterdam, Netherlands
Single port surgery of rectal tumours may be associated with shorter learning curve and fewer costs than transanal endoscopic microsurgery (TEM). A semicircumferent adenoma located 6-12cm from the anus was successfully resected using a single-site access system transanally. Endoluminal features were comparable to TEM. Full thickness, en bloc resection was possible. The defect was sutured transversally with continuous self-anchoring sutures. Operating time was 55 min. Blood loss was nil. The patient was hospitalized overnight. Histopathology showed tubulovillous adenoma with focal high grade dysplasia, radically resected. Single port transanal surgery may become an alternative to TEM.
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