Transanal excision of a rectal adenoma using single-access laparoscopic port

Abstract

Many rectal tumors can be excised transanally using inexpensive equipment. Transanal endoscopic microsurgery allows excision of lesions beyond the reach of conventional technique. Transanal endoscopic microsurgery is performed with specialized expensive instruments. Surgeons working in smaller community hospitals lack the budget to purchase transanal endoscopic microsurgery instruments. I modified the transanal endoscopic microsurgery technique by using a single-incision laparoscopic port that was inserted into the anal canal. Through this port, insufflation with gas maintained exposure of the surgical site, a 30-degree 5-mm camera, a grasper, and electrocautery were used to remove a large villous adenoma. This is the first report of the use of a single-access port to perform transanal endoscopic microsurgery. This modification is inexpensive compared with traditional transanal endoscopic microsurgery and allows more surgeons to perform difficult transanal tumor excisions (see Video, Supplemental Digital Content 1, http://links.lww.com/DCR/A39).