{"paper_id":"6c663bd9-84f5-41c4-a862-48866e0d2dc6","body_text":"Abstract\nThe combination of standard laparoscopy and specimen extraction through a natural orifice has the potential to decrease wound related complications. We describe the technical approach to laparoscopic sigmoidectomy in which the specimen is extracted transanally through a proctoscope. Laparoscopic-assisted sigmoidectomy with transanal specimen removal avoids an abdominal wall extraction incision and may be considered an alternative approach to conventional minimally invasive sigmoidectomy in patients with disease of the sigmoid or left colon.\nSimilar content being viewed by others\nReferences\nJacobs M, Verdeja JC, Goldstein HS (1991) Minimally invasive colon resection (laparoscopic colectomy). Surg Laparosc Endosc 1:144–150\nLiberman MA, Philips EH, Carrol BJ et al (1996) Laparoscopic vs traditional colectomy for diverticulitis: outcome and costs. Surg Endosc 10:15–18\nSher ME, Agachan F, Bortul M et al (1997) Laparoscopic surgery for diverticulitis. Surg Endosc 11:264–267\nVeldkamp R, Kugry E, Hop W et al (2005) Laparoscopic surgery versus open surgery for colon cancer: short term outcomes of a randomised trial. Lancet Oncol 6:477–484\nSenagore A, Duepree H, Delaney C et al (2002) Cost structure of laparoscopic and open sigmoidectomy for diverticular disease: similarities and differences. Dis Colon Rectum 45:485–490\nMatsuda T, Ogura K, Uchida J et al (1995) Smaller ports result in shorter convalescence after laparoscopic varicocelectomy. J Urol 153:1175–1177\nMorino M, Parini U, Giraudo G et al (2003) Laparoscopic total mesorectal excision. A consecutive series of 100 patients. Ann Surg 237:335–342\nLee S, Yoo J, Dujovny N et al (2006) Laparoscopic vs. hand-assisted laparoscopic sigmoidectomy for diverticulitis. Dis Colon Rectum 49:464–469\nDesai MM, Rao PP, Aron M et al (2008) Scarless single port transumbilical nephrectomy and pyeloplasty: first clinical report. BJU Int 101:83–88\nRemzi FH, Kirat HT, Kaouk JH et al (2008) Single-port laparoscopy in colorectal surgery. Colorectal Dis 10:823–826\nLeroy J, Cahill RA, Peretta S et al (2008) Single port sigmoidectomy in an experimental model with survival. Surg Innov 15:260–265\nBoni L, Tenconi S, Beretta A et al (2007) Laparoscopic colorectal resections with transvaginal specimen extraction for severe endometriosis. Surg Oncol 16:S157–S160\nWilson JI, Dogiparthi KK, Hebblethwaite N et al (2007) Laparoscopic right hemicolectomy with posterior colpotomy for transvaginal specimen retrieval. Colorectal Dis 9:662\nDozois EJ, Larson DW, Dowdy SC et al (2008) Transvaginal colonic extraction following combined hysterectomy and laparoscopic total colectomy: a natural orifice approach. Tech Coloproctol 12:251–254\nFranklin ME Jr, Kelley H, Kelley M et al (2008) Transvaginal extraction of the specimen after total laparoscopic right hemicolectomy with intracorporeal anastomosis. Surg Laparosc Endosc Percutan Tech 18:294–298\nLacy AM, Delgado S, Rojas OA et al (2008) MA-NOS radical sigmoidectomy: report of a transvaginal resection in the human. Surg Endosc 22:1717–1723\nPalanivelu C, Rangarajan C, Jategaonkar PA et al (2008) An innovative techique for colorectal specimen retrieval: a new era of “Natural Orifice Specimen Extraction” (N.O.S.E.). Dis Colon Rectum 51:1120–1124\nAmbroze WL, Organgio GR, Tucker JG et al (1993) Laparoscopic assisted proctosigmoidectomy with extracorporeal transanal anastomosis. A pilot study. Surg Endosc 7:29–32\nWhiteford MH, Denk PM, Swanström LL (2007) Feasibility of radical sigmoid colectomy performed as natural orifice translumenal endoscopic surgery (NOTES) using transanal endoscopic microsurgery. Surg Endosc 21:1870–1874\nDenk PM, Swanström LL, Whiteford MH (2008) Transanal endoscopic microsurgical platform for natural orifice surgery. Gastrointest Endosc 68:954–959\nLeroy J, Cahill RA, Peretta S et al (2009) Natural orifice translumenal endoscopic surgery (NOTES) applied totally to sigmoidectomy: an original technique with survival in a porcine model. Surg Endosc 23:24–30\nFranklin ME, Kazantsev GB, Abrego D et al (2000) Laparoscopic surgery for stage III colon cancer. Long-term follow-up. Surg Endosc 14:612–616\nLarson DW, Dozois E, Sandborn WJ et al (2005) Total laparoscopic proctocolectomy with Brooke ileostomy: a novel incisionless surgical treatment for patients with ulcerative colitis. Surg Endosc 19:1284–1287\nSylla P, Willingham FF, Sohn DK et al (2008) NOTES rectosigmoid resection using transanal microsurgery (TEM) with transgastric endoscopic assistance: a pilot study in swine. J Gastrointest Surg 12:1717–1723\nAuthor information\nAuthors and Affiliations\nCorresponding author\nRights and permissions\nAbout this article\nCite this article\nKnol, J., D’Hondt, M., Dozois, E.J. et al. Laparoscopic-assisted sigmoidectomy with transanal specimen extraction: a bridge to NOTES?. Tech Coloproctol 13, 65–68 (2009). https://doi.org/10.1007/s10151-009-0461-y\nReceived:\nAccepted:\nPublished:\nIssue date:\nDOI: https://doi.org/10.1007/s10151-009-0461-y","source_license":"public-domain-us","license_restricted":false}