Case Report
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World J Gastrointest Surg. Feb 27, 2012; 4(2): 41-44
Published online Feb 27, 2012. doi: 10.4240/wjgs.v4.i2.41
Hybrid natural orifice transluminal endoscopic surgery for ileocecal resection
Satoru Takayama, Masayasu Hara, Mikinori Sato, Hiromitsu Takeyama
Satoru Takayama, Masayasu Hara, Mikinori Sato, Hiromitsu Takeyama, Department of Gastroenterological Surgery, Nagoya City University Graduate School of Medical Sciences, Nagoya, 467-8601 Aichi, Japan
Author contributions: Takayama S designed and wrote this study; Hara M, Sato M and Takeyama H also contributed to this study.
Correspondence to: Satoru Takayama, MD, Department of Gastroenterological Surgery, Nagoya City University Graduate School of Medical Sciences, Nagoya, 467-8601 Aichi, Japan. takasato@med.nagoya-cu.ac.jp
Telephone: +81-52-8538226 Fax: +81-52-8423906
Received: February 20, 2011
Revised: October 31, 2011
Accepted: November 10, 2011
Published online: February 27, 2012
Abstract

Although laparoscopic colectomy is commonly performed around the world, an operative wound formed during the surgery is large but not sufficient enough to convert for the majority of open surgery. Thus, a certain sized skin incision is required to remove the resected colon. Here we report the case of a pure laparoscopic ileocecal resection which involves transanal specimen extraction. We present a case characterized by a laterally spreading type of tumor of the cecum. We performed a pure laparoscopic ileocecal resection and the resected specimen was removed transanally using colonoscopy. Intracorporeal functional anastomosis was then performed using a flexible linear stapling device under supporting barbed suture traction. The patient was discharged without complications on postoperative day 4. Laparoscopic colectomy performed with minimal incision could essentially increase the usage of this surgical technique. Although our method is restricted to flat or small lesions, we think it is a feasible and realistic solution for minimization of operative invasion because it involves specimen extraction through a natural orifice.

Keywords: Laparoscopic ileocecal resection; Natural orifice transluminal endoscopic surgery; Transanus; Barbed suture