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DOI: 10.1055/s-0032-1329301
Transanal ileoproctostomy in a human cadaver
Objective of the study: The technical feasibility of ileorectal by-pass (ileoproctostomy), performed entirely through a transanal access, was previously evaluated and demonstrated in a porcine model. The aim of this study was to verify the technical feasibility of the same operation in a human cadaver.
Methods and procedures: The procedure was carried out in a human male cadaver. A Transanal Endoscopic Microsurgery (TEM) device and endoscopic instruments were utilized.
Results: The study demonstrates that ileorectal bypass through a transanal access is technically feasible in humans. The principal steps of the procedure are:
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TEM device placement;
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rectal perforation above the peritoneal reflection;
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peritoneoscopy using a standard gastroscope;
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grasping the small bowel with retrieval forceps and pulling it through the rectal hole;
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suturing the ileum and the rectum together through the TEM device
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opening the ileal loop followed by endoscopic exploration
Conclusions based on the results: Ileorectal bypass through a transanal access is technically feasible in humans and although still at an experimental stage, it could become a surgical option in the treatment of some types of colonic strictures.