TAMIS management of large peritoneal entry for recurrent rectal polyp: A video vignette

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codi.15996.pdf(1.27 MB)
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Date
2021-11-22
Authors
Flanagan, Michael
Ryan, Jessica M.
Connelly, Tara
Cooke, Fiachra
McCullough, Peter
Neary, Peter
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John Wiley & Sons Inc.
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Abstract
Factors which influence decision making in choice of approach for rectal tumours include patient factors, oncologic factors and size and location of the tumour. In the setting of recurrent polyps, transanal excision is an appropriate modality of treatment. We present a video vignette of transanal minimally invasive surgery (TAMIS) for an anterior recurrent rectal poylp and management of a massive peritoneal entry. The polyp was 4cm in size and 8cm from the anal verge. With the patient in the prone jackknife position, we insert a GelPOINT™ Path Transanal Access Platform (Applied Medical, Rancho Santa Margarita, CA, USA) in combination with the AirSeal™ insufflation system (Conmed, Niagara. Falls, ON, Canada) to maintain pneumorectum. Breach into the peritoneal cavity was repaired with continuous V-Loc suture and checked transabdominally with an air leak test performed laparoscopically. The patient was discharged home well post operative day 1. Final histology revealed tubulovillous adenoma with low grade dysplasia and 5 benign reactive lymph nodes in the adjacent fat. TAMIS is a cost effective and safe treatment modality for patients with large recurrent rectal polyps. We demonstrate in this video the effective management of a large peritoneal entry using TAMIS.
Description
Video vignette
Keywords
Polyp , TAMIS
Citation
Flanagan, M., Ryan, J. M., Connelly, T., Cooke, F., McCullough, P. and Neary, P. (2021) 'TAMIS management of large peritoneal entry for recurrent rectal polyp: A video vignette', Colorectal Disease. doi: 10.1111/codi.15996
Copyright
© 2021, Wiley Periodicals LLC. This is the peer reviewed version of the following item: Flanagan, M., Ryan, J. M., Connelly, T., Cooke, F., McCullough, P. and Neary, P. (2021) 'TAMIS management of large peritoneal entry for recurrent rectal polyp: A video vignette', Colorectal Disease, doi: 10.1111/codi.15996, which has been published in final form at https://doi.org/10.1111/codi.15996. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Use of Self-Archived Versions.