-

Öz

Transanal endoscopic microsurgery is a minimally invasive procedure for the pathologies in the rectum. Transanal endoscopic microsurgery can be performed using a laparoscopic single port. In this study, we intended to represent our first case in which we used the singleport laparoscopic transanal endoscopic microsurgery for the excision of a rectal polyp. The single port was incorporated into the anal canal and then this port was fixed by sutures to the perianal area. The polyp was entirely resected with the help of standard and two angled laparoscopic surgical instruments. There were no postoperative complications and the patient was discharged on the first postoperative day. The histopathological examination revealed that focal high-grade dysplasia detected in the resection material surgical margins were negative. As a result, resection of rectal polyp in the anal canal by applying single-port laparoscopic surgery with the help of hand tools was found to be safe and feasible

Anahtar Kelimeler

• -

Tek Port ile Laparoskopik Transanal Endoskopik Mikrocerrahi: Bir Vaka Takdimi

Öz

Transanal endoskopik mikrocerrahi, rektumda bulunan patolojiler için minimal invaziv bir girişim olup, tek portun transanal endoskopik mikrocerrahide kullanımı mümkündür. Bu çalışmada, merkezimizde ilk kez tek port transanal laparoskopik cerrahi yöntemi ile yaptığımız rektal polip eksizyonu olgusunun sunumunu amaçlandık. Tek port, anal kanala yerleştirildikten sonra perianal bölgeye sütürlerle tespit edildi. Standart ve açılı laparoskopik cerrahi aletler yardımı ile rektumdaki polip rezeksiyonu tam kat gerçekleştirildi. Operasyon sonrası komplikasyon gelişmeyen hasta postoperatif birinci günde taburcu edildi. Histopatolojik incelemede, fokal yüksek dereceli displazi tespit edilen rezeksiyon materyalinin cerrahi sınırları negatif idi. Sonuç olarak, rektal polip rezeksiyonunun, anal kanala tek port uygulanarak laparoskopik cerrahi el aletleri yardımıyla rezeksiyonunun mümkün ve güvenli olduğu görüldü.

Anahtar Kelimeler

• Rektal Polip, Tek Port, Transanal Endoskopik Mikrocerrahi

Kaynakça

1. Leslie A, Carey FA, Pratt NR, Steele RJ. The colorectal adenoma-carcinoma sequence. Br J Surg 2002; 89: 845-60.
2. Middleton PF, Sutherland LM, Maddern GJ. Transanal endoscopic microsurgery: a systematic review. Dis Colon Rectum 2005; 48: 270-84.
3. Darwood RJ, Wheeler JM, Borley NR. Transanal endoscopic microsurgery is a safe and reliable technique even for complex rectal lesions. Br J Surg 2008; 95: 915-8.
4. Saclarides TJ. Transanal endoscopic microsurgery. Surg Clin North Am 1997; 77: 229-39.
5. Said S, Stippel D. Transanal endoscopic microsurgery in large, sessile adenomas of the rectum. A 10-year experience. Surg Endosc 1995; 9: 1106-12.
6. Winde G, Schmid KW, Reers B, Bünte H. Microsurgery in prospective comparison with conventional transanal excision or anterior rectum resection in adenomas and superficial carcinomas. Langenbacks Arch Chir Suppl Kongressbd 1996; 113: 265-8.
7. Mörschel M, Heintz A, Bussmann M, Junginger T. Follow up after transanal endoscopic microsurgery or transanal excision of large benign rectal polips. Langenbecks Arch Surg 1998; 383: 320-4.
8. Nagy A, Kovacs T, Berki C, Jano Z. Surgical management of villous and tubulovillous adenomas of the rectum. Orv Hetil 1999; 140: 2215-9.

9. Maslekar S, Pillinger SH, Monson JR. Transanal endoscopic micro surgery for carcinoma of the rectum. A 10-year experience. Surg Endosc 1995; 9: 1106-12.
10. Endreseth BH, Wibe A, Svinsas M. Marvik R,Myrvold HE. Postoperative morbidity and recurrence after local excision of rectal adenomas and rectal cancer by transanal endoscopic microsurgery. Colorectal Dis 2005; 7: 133-7.
11. Buess G, Theiss R, Gunther M, Hutterer F, Pichlmaier H. Transanal endoscopic microsurgery. Leber Magen Darm 1985; 15: 271-9.