Laparoscopic natural orifice specimen extraction surgery(NOSES)IV for high rectal cancer
LU Sheng
ZHANG Ming
DING Chuang
Abstract：The patient was an elderly male diagnosed with high rectal cancer,and underwent laparoscopic radical resection using the natural orifice specimen extraction surgery(NOSES)IV approach.According to the principles of total mesorectal excision(TME),the dissection was performed with a distal margin of at least 10 cm beyond the inferior border of the tumor.Following transanal irrigation of the rectal lumen with povidone-iodine solution,the distal rectum was ligated and transected 5 cm below the tumor using an endoscopic linear stapler.A sterile specimen retrieval bag was introduced through the distal rectal opening and advanced to the anal verge,establishing a sterile intracorporeal pathway within the distal intestinal lumen.Proximally,the colon was skeletonized 10 cm above the superior tumor margin,ligated,and divided.The specimen was then extracted through the rectal lumen using the sterile retrieval system.A laparoscopic purse-string suture was placed at the proximal colon to embed the anvil of the circular stapler,followed by transanal anastomosis.For patients with high rectal cancer,the NOSES IV technique is both safe and feasible,offering significant advantages,including reduced postoperative pain and accelerated recovery.
Keywords：high rectal cancernatural orifice specimen extraction surgerytotal laparoscopy
Publication Date：2025-10-20
Online Publishing Date：2025-12-11(First online date of this platform, not the publication date of the document)
Pages：2( 27-28 )