Direct target NOTES: prospective applications for next generation robotic platforms
ConclusionsA flexible robotic system has the potential to access anatomy along circuitous paths, making it a suitable platform for direct target NOTES. The conceptual operations posed could be considered suitable for next generation robotics once the technology is optimized, and after further preclinical validation. (Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - May 31, 2018 Category: Surgery Source Type: research

Levator ani syndrome: transperineal botox injections
(Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - May 31, 2018 Category: Surgery Source Type: research

Outcomes of endoscopic pilonidal sinus treatment (EPSiT): a systematic review
ConclusionsInitial studies on EPSiT have shown promising results. However, there is a need for a standardised technique and more comparative studies to validate this novel procedure. (Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - May 31, 2018 Category: Surgery Source Type: research

Embolization of superior rectal arteries for transfusion dependent  haemorrhoidal bleeding in severely cardiopathic patients: a new field of application of the “emborrhoid” technique
(Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - May 24, 2018 Category: Surgery Source Type: research

Colonic conduit prolapse after transanal total mesorectal excision (taTME)
(Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - May 24, 2018 Category: Surgery Source Type: research

Purse-string rupture: pitfalls of transanal total mesorectal excision (Cecil approach)
(Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - May 23, 2018 Category: Surgery Source Type: research

Botulin toxin injection to improve the results of sphincter overlap in high grade obstetric anal sphincter injury syndrome
(Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - May 21, 2018 Category: Surgery Source Type: research

A gastric feeding tube as a non-traumatic fistula probe during anal fistula repair
(Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - May 21, 2018 Category: Surgery Source Type: research

Endoscopic submucosal injection: a novel technique facilitating  dissection in transanal minimally invasive surgery (TAMIS)
(Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - May 16, 2018 Category: Surgery Source Type: research

15th International Coloproctology Meeting
(Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - May 15, 2018 Category: Surgery Source Type: research

Intraoperative check for enterocele in perineal stapled prolapse resection
(Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - May 15, 2018 Category: Surgery Source Type: research

Sitz bath and keyhole deformity in benign anorectal disorders
(Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - May 15, 2018 Category: Surgery Source Type: research

Tumour response to neoadjuvant chemoradiation within lateral pelvic nodes: another step towards precision surgery
(Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - May 10, 2018 Category: Surgery Source Type: research

Prophylactic mesh reinforcement of stomas: a cost-effectiveness meta-analysis of randomised controlled trials
ConclusionsReinforcing elective stomas with mesh (primarily synthetic) reduces subsequent PSH rates, complications, repairs and saves money. We recommend that future RCTs compare mesh subtypes, techniques, and applicability to emergency stomas. (Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - May 7, 2018 Category: Surgery Source Type: research

The Pediatric Colorectal and Pelvic Learning Consortium (PCPLC): rationale, infrastructure, and initial steps
(Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - May 4, 2018 Category: Surgery Source Type: research

Salvage TME following TEM: a possible indication for TaTME
AbstractBackgroundSalvage surgery  after transanal endoscopic microsurgery (TEM) has shown mixed results. Transanal total mesorectal excision (TaTME) might be advantageous in this population. The aim of this study was to assess the short-term oncologic and operative outcomes of salvage surgery after TEM, comparing TaTME to convent ional salavge TME (sTME).MethodsConsecutive patients treated with salvage surgery after TEM were identified. Patients who underwent TaTME were compared to those who had conventional  sTME. The primary outcome was the ability to perform an appropriate oncologic procedure define...
Source: Techniques in Coloproctology - May 4, 2018 Category: Surgery Source Type: research

Application of an enhanced recovery pathway for ileostomy closure: a case –control trial with surprising results
AbstractBackgroundEnhanced recovery after surgery (ERAS) protocols have been widely validated in colorectal surgery; however, few data exist on loop ileostomy closure. The aim of this study was to compare clinical outcomes before and after introduction of ERAS for loop ileostomy closure.MethodsData on outcomes after loop ileostomy closure were retrospectively collected before ERAS was applied at our department (control group). These results were compared to results of patients undergoing loop ileostomy closure within the original colorectal ERAS pathway (ERAS 1 group); after analysis of these results, adaptations were made...
Source: Techniques in Coloproctology - May 3, 2018 Category: Surgery Source Type: research

Adipose-derived stem cells (MYSTEM ® EVO Technology) as a treatment for complex transsphincteric anal fistula
(Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - May 2, 2018 Category: Surgery Source Type: research

Bowel perforation in type IV vascular Ehlers –Danlos syndrome. A systematic review
AbstractSpontaneous gastrointestinal (GI) perforation is a well-known complication occurring in patients suffering from Type IV vascular Ehlers –Danlos syndrome (EDS IV). The aim of the present study was to review the current literature on spontaneous GI perforation in EDS IV and illustrate the surgical management and outcome when possible. A systematic review of all the published data on EDS IV patients with spontaneous GI perforation be tween January 2000 and December 2015 was conducted using three major databases PUBMED, EMBASE, and Cochrane Central Register of Controlled Trails. References of the selected article...
Source: Techniques in Coloproctology - April 26, 2018 Category: Surgery Source Type: research

A systematic review of minimally invasive surgery for retrorectal tumors
Abstract Retrorectal tumors are rare tumors that require resection for symptoms, malignancy and potential malignant transformation. Traditional approaches have included laparotomy, perineal excision or a combination. Multiple minimally invasive techniques are available which have the potential to minimize morbidity and enhance recovery. We performed a systematic review of the literature to determine the feasibility and surgical outcomes of retrorectal tumors approached using minimally invasive surgical techniques. Publications in which adult patients ( ≥ 18 years) had a minimally invasive approach (laparos...
Source: Techniques in Coloproctology - April 20, 2018 Category: Surgery Source Type: research

Diagnostic value of FDG-PET/CT for lateral pelvic lymph node metastasis in rectal cancer treated with preoperative chemoradiotherapy
AbstractBackgroundThe aim of this study was to elucidate the diagnostic value of18F-fluorodeoxyglucose positron emission tomography (PET) –computed tomography (CT) for lateral pelvic lymph node (LPN) metastasis in rectal cancer treated with preoperative chemoradiotherapy (CRT).MethodsEighteen rectal cancer patients with enlarged ( ≥ 8 mm) LPNs were treated with CRT followed by total mesorectal excision with LPN dissection during 2012–2015. After CRT, LPN maximum standard uptake values (SUVmax) were measured using PET/CT and long diameters of LPNs were measured using CT or magnetic resonance imagi...
Source: Techniques in Coloproctology - April 6, 2018 Category: Surgery Source Type: research

A novel technique for minimally invasive removal of a foreign body in the rectal wall
(Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - April 3, 2018 Category: Surgery Source Type: research

A case of local recurrence following transanal total mesorectal excision: a new form of port-site metastasis?
(Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - April 3, 2018 Category: Surgery Source Type: research

A transvaginal approach to rectovaginal fistulae for the colorectal surgeon: technical notes and case series
We report 15 cases of RVF (nine recurrent) treated by this technique at a single UK centre. The healing rate was 67%. There were no major complications. Median follow-up was 48  months. (Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - March 30, 2018 Category: Surgery Source Type: research

Pelvic floor function following ventral rectopexy versus STARR in the treatment of obstructed defecation
ConclusionsVRP and STARR can improve defecation in patients with ODS with minimal complications, but the overall pelvic wellness evaluated by the TAPE score improves significantly only after VRP, suggesting a better performance of VRP than STARR when overall pelvic floor function is concerned. (Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - March 28, 2018 Category: Surgery Source Type: research

Transanal total mesorectal excision for rectal cancer: evaluation of the learning curve
ConclusionsThe learning curve of TaTME affected major (surgical) postoperative complications for the first 40 patients. A two-team approach decreased operative time and conversion rate. When implementing this new technique, a thorough teaching and supervisory program is recommended to shorten the learning curve and improve the clinical outcomes of the first patients. (Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - March 22, 2018 Category: Surgery Source Type: research

Feasibility of fluorescence lymph node imaging in colon cancer: FLICC
ConclusionsICG can be safely injected into the peritumoural subserosal and demonstrate lymphatic drainage in colon cancer. This proof of concept and proposed standards for the procedure can lead to future studies to optimize the application of image-guided precision surgery in colon cancer. Furthermore, this technique may be of value in indicating the need for more extended lymphadenectomy. (Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - March 17, 2018 Category: Surgery Source Type: research

Perioperative outcomes and adverse events of robotic colorectal resections for inflammatory bowel disease: a systematic literature review
AbstractThe purpose of this study was to assess outcome measures and cost-effectiveness of robotic colorectal resections in adult patients with inflammatory bowel disease. The Cochrane Library, PubMed/Medline and Embase databases were reviewed, using the text “robotic(s)” AND (“inflammatory bowel disease” OR “Crohn’s” OR “Ulcerative Colitis”). Two investigators screened abstracts for eligibility. All English language full-text articles were reviewed for specified outcomes. Data were presented in a summarised and aggregate form, since th e lack of higher-level evidence s...
Source: Techniques in Coloproctology - March 15, 2018 Category: Surgery Source Type: research

Outcomes of primary anal sphincter repair after obstetric injury and evaluation of a novel three-choice assessment
ConclusionsAfter 6  months, severe symptoms after OASIS repair were present in 9% of women and were more frequent in older women, women with high-degree tears and after instrumental vaginal delivery. A three-choice assessment of AI symptoms correlated well with the Wexner score and might be useful to triage patients who need further evaluation. (Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - March 15, 2018 Category: Surgery Source Type: research

The effect of metabolic syndrome on postoperative outcomes following laparoscopic colectomy
AbstractBackgroundAmong the criteria used to diagnose metabolic syndrome (MS), obesity and diabetes mellitus (DM) are associated with poor postoperative outcomes following colectomy. MS is also associated with colorectal cancer (CRC) and diverticulosis, both of which may be treated with colectomy. However, the effect of MS on postoperative outcomes following laparoscopic colectomy has yet to be clarified.MethodsIn an academic tertiary hospital, data from all consecutive patients undergoing laparoscopic colectomy from 2005 to 2014 were prospectively recorded and analysed. Patients presenting with MS [defined by the presence...
Source: Techniques in Coloproctology - March 14, 2018 Category: Surgery Source Type: research

Teaching TransAnal Irrigation (TAI): why it is mandatory
(Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - March 12, 2018 Category: Surgery Source Type: research

What to consider when designing a laparoscopic colorectal training curriculum: a review of the literature
AbstractMultiple studies have demonstrated the benefits of laparoscopic colorectal surgery (LCS), but in several countries it has still not been widely adopted. LCS training is associated with several challenges, such as patient safety concerns and a steep learning curve. Current evidence may facilitate designing of efficient training curricula to overcome these challenges. Basic training with virtual reality simulators has witnessed meteoric advances and may be essential during the early parts of the learning curve. Cadaveric and animal model training still constitutes an indispensable training tool, due to a higher degre...
Source: Techniques in Coloproctology - March 6, 2018 Category: Surgery Source Type: research

The clinical value of magnetic resonance defecography in males with obstructed defecation syndrome
AbstractBackground The aim of the present study was to assess the relationship between symptoms of obstructed defecation and findings on magnetic resonance (MR) defecography in males with obstructed defecation syndrome (ODS).Methods Thirty-six males with ODS who underwent MR defecography at our institution between March 2013 and February 2016 were asked in a telephone interview about their symptoms and subsequent treatment, either medical or surgical. Patients were divided into 2 groups, one with anismus (Group 1) and one with prolapse without anismus (Group 2). The interaction between ODS type and symptoms with MR fin...
Source: Techniques in Coloproctology - March 6, 2018 Category: Surgery Source Type: research

Perioperative hyperglycemia: an unmet need within a surgical site infection bundle
AbstractBackgroundThe aim of this study was to determine whether perioperative stress hyperglycemia is correlated with surgical site infection (SSI) rates in non-diabetes mellitus (DM) patients undergoing elective colorectal resections within an SSI bundle.MethodsAmerican College of Surgeons National Surgical Quality Improvement Program data of patients treated at a single institution in 2006 –2012 were supplemented by institutional review board-approved chart review. A multifactorial SSI bundle was implemented in 2009 without changing the preoperative 8-h nil per os, and in the absence of either a carbohydrate loadi...
Source: Techniques in Coloproctology - March 6, 2018 Category: Surgery Source Type: research

Preliminary experience with umbilical stoma in transumbilical single-port colorectal surgery
ConclusionThis preliminary experience showed that u-stoma is a feasible and safe alternative to more conventional ostomy after SILS. (Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - March 6, 2018 Category: Surgery Source Type: research

The impact of complications after elective colorectal resection within an enhanced recovery pathway
AbstractBackground Despite the implementation of enhanced recovery pathways (ERP), morbidity following colorectal surgery remains high. The aim of the present study was to estimate the impact of postoperative complications on excess hospital length of stay (LOS) in patients undergoing elective colorectal resection.MethodsA retrospective study of patients undergoing elective colorectal surgery at a single institution from 2003 to 2010 was performed. Patients managed by an ERP were compared to conventional care (CC), matched by propensity score radius matching. Complications were defined a priori. Excess (independent effec...
Source: Techniques in Coloproctology - March 5, 2018 Category: Surgery Source Type: research

Endoluminal vacuum-assisted therapy as treatment for anastomotic leak after ileal pouch –anal anastomosis: a pilot study
ConclusionsEndosponge® is effective as the only treatment after IPAA leak. Based on the results of our prospective pilot study, application of Endosponge® should be the treatment of choice in selected pouch anastomotic leaks not requiring immediate surgery. These results will have to be confirmed by future prospective studies including a larger number of patients. (Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - March 3, 2018 Category: Surgery Source Type: research

Correction to: Transanal hemorrhoidal dearterialization (THD) for hemorrhoidal disease: a single-center study on 1000 consecutive cases and a review of the literature
AbstractThe article “Transanal hemorrhoidal dearterialization (THD) for hemorrhoidal disease: a single-center study on 1000 consecutive cases and a review of the literature” written by C. Ratto et al. was originally published Online First without open access. (Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - February 28, 2018 Category: Surgery Source Type: research

Different approaches for Endo-SPONGE ® insertion to treat rectal anastomotic leaks
(Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - February 26, 2018 Category: Surgery Source Type: research

Random duodenal biopsy to exclude coeliac disease as a cause of anaemia is not cost-efective and should be replaced with universally performed pre-endoscopy serology in patients on a suspected cancer pathway
ConclusionsRandom duodenal biopsy is not a cost-effective method of diagnosing coeliac disease and should be replaced with pre-endoscopy coeliac serology. (Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - February 23, 2018 Category: Surgery Source Type: research

Response to: the nearly complete TME quality conundrum
(Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - February 23, 2018 Category: Surgery Source Type: research

Reply to correspondence by Smart and Watson
(Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - February 22, 2018 Category: Surgery Source Type: research

Editor ’s reply to “Mobile applications for colorectal surgery journals: Do we really need them?”
(Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - February 21, 2018 Category: Surgery Source Type: research

Improved urethral fluorescence during low rectal surgery: a new dye and a new method
ConclusionsThe newly described ICG-silicone method opens up the possibility of new technologies in this area of fluorescence guided surgery. IRDye800BK is a promising alternative to ICG in visualising the urethra using fluorescence imaging. Its greater depth of penetration may allow earlier detection of the urethra during surgery and prevent wrong plane surgery sooner. (Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - February 19, 2018 Category: Surgery Source Type: research

Micro-fragmented adipose tissue injection for the treatment of complex anal fistula: a pilot study accessing safety and feasibility
ConclusionsThe injection of autologous, micro-fragmented and minimally manipulated adipose tissue associated with closure of the internal opening is a safe, feasible and reproducible procedure and may enhance complex anal fistula healing. (Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - February 16, 2018 Category: Surgery Source Type: research

Reply to the letter to the editor regarding: A prospective randomized trial evaluating the outcomes of transanal hemorrhoidal dearterialization versus tissue-selecting technique
(Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - February 12, 2018 Category: Surgery Source Type: research

Effective use of ustekinumab for prepouch ileitis without improvement of concomitant pouchitis
(Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - February 9, 2018 Category: Surgery Source Type: research

EndoRectal ProctoPexy (ERPP) for recurrent semi-circumferential rectal polyp
(Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - February 9, 2018 Category: Surgery Source Type: research

Local excision of a giant colonic lipoma
(Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - February 3, 2018 Category: Surgery Source Type: research

Videodefecography is still superior to magnetic resonance defecography in the study of obstructed defecation syndrome
(Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - January 24, 2018 Category: Surgery Source Type: research