Annals of Coloproctology

Technical Note

Minimally invasive surgery

Robotic natural orifice specimen extraction surgery (NOSES) for anterior resection: Toan Duc Pham, Tomas Larach, Bushra Othman, Amrish Rajkomar, Alexander G. Heriot, Satish K. Warrier, Philip Smart; Ann Coloproctol. 2023;39(6):526-530. Published online December 19, 2023; DOI: https://doi.org/10.3393/ac.2022.00458.0065

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Minimally invasive colorectal surgery is currently well-accepted, with open techniques being reserved for very difficult cases. Laparoscopic colectomy has been proven to have lower mortality, complication, and ostomy rates; a shorter median length of stay; and lower overall costs when compared to its open counterpart. This trend is seen in both benign and malignant indications. Natural orifice specimen extraction surgery (NOSES) in colorectal surgery was first described in the early 1990s. Three recent meta-analyses comparing transabdominal extraction against NOSES concluded that NOSES was superior in terms of overall postoperative complications, recovery of gastrointestinal function, postoperative pain, aesthetics, and hospital stay. However, NOSES was associated with a longer operative time. Herein, we present our technique of robotic NOSES anterior resection using the da Vinci Xi platform in diverticular disease and sigmoid colon cancers.

Citations

Citations to this article as recorded by

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Review

Motility Disorders of the Colon.: Lee, Sang Jeon; J Korean Soc Coloproctol. 2005;21(5):337-353.

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Abstract PDF: Human colonic motor activity is quite a complex issue and is a relatively difficult topic to investigate, still only partly understood and investigated, due to anatomic and physiological difficulties. Colonic motility measurement are hampered by the relative inaccessibility of the colon, especially in the unprepared state. Major motor events are infrequent, necessitating long observation periods. Moreover, correlating intraluminal pressure changes with stool transport is difficult. Disturbances of normal colonic motor activity may interfere with healthy colonic physiologic function. The pathophysiological mechanisms responsible for colonic motility disorders are still less understood. In recent years, however, some more data have been obtained, even in proximal segments. These data have helped in elucidating, although only in part, some pathophysiological mechanisms of colonic motility disorders. In this review article, after a brief of relevant normal aspects of colorectal motility in man, we limit our discussion to more common motility disorders involving the colon and rectum. In particular, what is known or hypothesized regarding the underlying pathophysiology of slow-transit constipation, diverticular diseases, irritable bowel syndrome, and intestinal pseudo-obstruction is reviewed.

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