Glove Port Transanal Excision of Rectal Tumors an Alternative Method for Rectal Tumor Excision: Single Center Experience.

Abstract

Aim: Transanal minimal invasive surgery has been practiced for several years for excision of rectal tumors however there is no standard consensus about its applications. This minimally invasive approach helps in avoiding major rectal resections and its associated risk of mortality and morbidity.The aim of this study is to describe a single center experience with transanal glove port excision of rectal tumors which are not amenable to colonoscopic excision. Materials and Methods: Between the years 2011 and 2014, 9 patients underwent glove port excision of rectal tumors located within 15 cm from the anal verge. Glove port was constructed using circular anal dilator, standard surgical glove and a wound protector retractor; regular laparoscopic instruments were used. The median follow-up period was for 18 months (range, 9 to 27 mo) and all patients had flexible sigmoidoscopy for follow-up to look for any recurrence of the tumors. Results: All patients underwent transanal excision of rectal tumors successfully using glove port device and laparoscopic instruments. Full thickness excision of the tumor was performed in all patients and there was no significant postoperative morbidity. The final histology of 6 patients was benign and the remaining 3 patients had malignancy reported in the specimen. During the follow-up period between 12 and 18 months 3 patients had a recurrence of the polyp which was removed endoscopically without the need for any further surgical intervention. Conclusions: Glove port excision of rectal tumors is a feasible alternative to conventional surgical treatment for large benign rectal tumors.What does this paper add to the literature?This article demonstrates that performing local excision of rectal tumors can be achieved safely at a lower cost using simple platforms that are constructed locally like the glove ports. It also highlights the benefits of using the available laparoscopic kits to perform the procedure while making use of the previously acquired skills.