Natural orifice specimen extraction with a modified reverse puncture device technique for total laparoscopic colorectal resection: feasibility and efficacy

Abstract

Objective: To evaluate the feasibility and efficacy of the modified reverse puncture device (mRPD) technique for transanal anastomosis in total laparoscopic colorectal resection with natural orifice specimen extraction surgery (NOSES).

Methods: From August 2015 to September 2017, 34 patients underwent laparoscopic colorectal resection using the mRPD technique to place the anvil in the abdominal cavity and complete transanal anastomosis.

Results: All patients who underwent total laparoscopic colorectal resection with NOSES were analyzed. The anvil placement time was 5–14 min, with an average of 6.7 min. The postoperative pain visual analogue scale (VAS) score was 1–4 points, with an average of 2.2 points. The postoperative hospital stay was 7–13 days, with an average of 8.7 days. No complications, such as anastomotic bleeding or stenosis, occurred. During a 14- to 28-month follow-up period (average, 19.5 months), no cases of long-term complications were observed.

Conclusion: Total laparoscopic colorectal resection using mRPD is a technically feasible and safe procedure with satisfactory short-term efficacy.

Keywords:

• Total laparoscope
• modified reverse puncture device technique
• natural orifice specimen extraction
• colorectal resection

Acknowledgements

The authors thank the patients, their families, the investigators and staff who participated in the study.

Ethical approval

The authors state that this study was approved by the Ethics Committee of Yijishan Hospital at Wannan Medical College and have followed the principles outlined in the Declaration of Helsinki for all human or animal experimental investigations. In addition, for investigations involving human subjects, informed consent has been obtained from the participants involved.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

This work was supported by the National Natural Science Foundation of China, Grant numbers: 81902515; University Natural Science Research Project of Anhui Province, Grant numbers: KJ2018A0247, KJ2017A272, KJ2019A0412, KJ2019A0429; Young and Middle Ages Scientific Research Fund Project of Wannan Medical College, Grant numbers: WK2018F01, WK2018F03; the Science and Technology Development Fund of Kangda College of Nanjing Medical University, Grant numbers: KD2019KYJJZD009; Health Science and technology project of Lianyungang, Grant numbers:201914; ‘Climbing’ Cultivation Plan for the Science and Technology Innovation Team of Yanjishan Hospital of Wannan Medical College, Grant numbers: PF2019009 and Key Laboratory of Non-coding RNA Transformation Research of Anhui Higher Education Institution (Wannan Medical College).