Transanal minimally invasive surgery for resection of retrorectal cyst

Abstract

Tailgut cysts are benign retrorectal embryological remnants, often found incidentally or when evaluating a patient for pelvic symptoms. Transanal minimally invasive surgery (TAMIS) offers patients a low morbidity surgical approach for resection of a variety of low rectal lesions. This is a case report of resection of a tailgut cyst using TAMIS, including images and description of the steps of the procedure.

Figure 1:

CT pelvis image demonstrating a 7.0 cm retrorectal cyst. The rectum is noted anterior to the cyst, and just to the right of midline.

Figure 2:

MRI pelvis demonstrating the retrorectal cysts, again with the rectum anterior and just to the right of midline.

Figure 3:

Opening of the posterior wall of the rectum, into the posterior perirectal space.

Figure 4:

Enlargement of the proctotomy. The plane of dissection is visible (indicated by arrows), with the dome of the cyst seen at the bottom of the image.

Figure 5:

The dome of the cyst is visible at the bottom of the image (indicated by arrow), with a dissection plane visualized above.

Figure 6:

Cavity of the resection site after cyst resection.