Laparoscopic Middle Rectal Cancer Resection with Transvaginal Specimen Extraction (CRC-NOSES III)

Abstract

NOSES III is mainly applicable to female patients with slightly larger rectal tumors. The main operating procedures of NOSES III include transvaginal rectal extraction, extra-corporeal specimen removal, and totally laparoscopic end-to-end anastomosis between sigmoid colon and rectum. Compared with NOSES II, the main features of NOSES III are as follows: (1) there is no need to open the bowel intracorporeally, which better meets the requirements of aseptic principle; (2) more stringent vaginal preparation is needed before operation; (3) because of the strong vaginal extensibility, the indications of NOSES III are wider, but this procedure is limited to female patients. Although there is difference between NOSES III and conventional laparoscopic rectal resection, this technology is entirely reasonable, safe, and feasible as long as surgeons have clear anatomic understanding and solid operating skills.