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Transanal circumferential mucosectomy for symptomatic benign rectal stenosis

G Dapri, MD, PhD, FACS, FASMBS, Hon FPALES, Hon SPCMIN, Hon BSS, Hon CBCD, Hon CBC N Bachir, MD L Antolino, MD K Grozdev, MD D Guta, MD K Jottard, MD GB Cadière, MD, PhD
Epublication WebSurg.com, Oct 2015;15(10). URL: http://websurg.com/doi/vd01en4593

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  • 2015-10-12
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Background: Transanal laparoscopy has been described for more than 30 years. In the presence of benign lesions, it gathers increasing interest, especially if such lesions are located in the low rectum or close to the anal margin. Video: This video demonstrates the case of a 38-year-old man presented with a circumferential rectal stenosis due to a rectal ulcer. The patient underwent a transanal mucosectomy using laparoscopy, after a sequence of unsuccessful endoscopic dilatations. Preoperative work-up showed a circumferential benign stenosis, 2.5cm away from the anal margin. The procedure was entirely performed with a new reusable transanal platform made up by the DAPRI-Port and DAPRI curved instruments (Karl Storz Endoskope, Tuttlingen, Germany). Once the 360-degree mucosectomy had been completed, the mucosal layer was repaired using separate absorbable sutures. Results: The operative length was 163 minutes, and peroperative bleeding was unsignificant. The patient was discharged on postoperative day 2. The pathological report confirmed the benign nature of the lesion. Conclusions: Although transanal laparoscopy has been documented for years, it gathers increasing interest and should be considered as the technique of choice for the treatment of benign rectal lesions, which can be difficult to treat using other methods.