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Ileorectal bypass performed entirely through a transanal route in a porcine model

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Abstract

Background

Natural orifice transluminal endoscopic surgery (NOTES), a new frontier of minimally invasive surgery, uses the body’s natural orifices to create an access for surgical procedures. This study aimed to verify the technical feasibility of ileorectal bypass performed entirely through a transanal access.

Methods

The procedure was performed on 10 domestic pigs, after which they were killed. A transanal endoscopic microsurgery (TEM) device and endoscopic and laparoscopic instruments were used.

Results

The findings demonstrated that an ileorectal bypass through a transanal access is feasible. The principal steps of a standardized transanal procedure are as follows: confirm a rectal perforation above the peritoneal reflection, perform peritoneoscopy using a standard gastroscope, grasp the small bowel with retrieval forceps and pull it through the rectal hole, suture the ileum and the rectum together using a TEM device, open the ileal loop, and perform endoscopic exploration. Satisfactory anastomosis and no signs of procedure-related complications were confirmed by a post procedure laparotomy.

Conclusions

Ileorectal bypass through a transanal access is technically feasible in a porcine model, and although still at an experimental stage, it could become a surgical option for treating some types of colonic strictures.

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Acknowledgment

The authors are grateful to Linda Inverso Moretti for editing the English version of this manuscript and to Silvio Ferron (Animal Surgical Experimental Centre) for his assistance with the technical aspects of these experiments.

Disclosures

Lino Polese, Imerio Angriman, Benedetto Mungo, Roberto Luisetto, Mauro Frego, Stefano Merigliano, and Lorenzo Norberto have no conflicts of interest or financial ties to disclose.

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Authors and Affiliations

  1. Surgical Endoscopy Unit, Department of Surgical and Gastroenterological Sciences, University of Padova, Padova, Italy

    Lino Polese, Imerio Angriman, Benedetto Mungo, Mauro Frego & Lorenzo Norberto

  2. Surgical Experimental Centre, Department of Surgical and Gastroenterological Sciences, University of Padova, Padova, Italy

    Roberto Luisetto & Stefano Merigliano

  3. Corso del Popolo 58/C, Mestre, 30172, Venezia, VE, Italy

    Lino Polese

Authors
  1. Lino Polese
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  2. Imerio Angriman
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  3. Benedetto Mungo
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  4. Roberto Luisetto
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  5. Mauro Frego
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  6. Stefano Merigliano
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  7. Lorenzo Norberto
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Correspondence to Lino Polese.

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Polese, L., Angriman, I., Mungo, B. et al. Ileorectal bypass performed entirely through a transanal route in a porcine model. Surg Endosc 25, 3022–3027 (2011). https://doi.org/10.1007/s00464-011-1664-7

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  • DOI: https://doi.org/10.1007/s00464-011-1664-7

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