Medical Teams Extract Rectal Mass Through Anus

BARCELONA—On Nov. 9, 2009, a team of surgeons carried out the first surgical removal of a rectal mass using the NOTES (natural orifice transluminal endoscopy surgery) approach and TEM (transanal endoscopic microsurgery) technique in the Hospital Clinic of Barcelona. The surgery was a collaboration between the gastrointestinal surgery team of the Hospital Clinic, and a team of surgeons from the Massachusetts General Hospital of Boston (Harvard University). This is the first time in the world that a rectal tumor has been excised using an approach through the anus.

The patient, a 76-year-old woman diagnosed with a malignant rectal tumor, was discharged home with no complications and excellent postoperative recovery on November 14, only five days after surgery. During the operation, nearly all surgical instruments were introduced through the anus to avoid painful abdominal incisions. This new technique has been developed to achieve better results than laparoscopic surgery, and is a minimally-invasive technique with many advantages: less pain, shorter hospital stay and safe oncologic results. Thanks to the joint work of this international team of experts, surgery has taken a step forward, with a successful operation to excise a rectal mass without leaving surgical scars, whereas even laparoscopic surgery requires four or five minimal incisions.

The TEM technique uses rectal endoscopy to introduce a specially-designed proctoscope connected to a CO2 insufflation system that dilates the rectum. This creates a working space that allows the instruments required to section and dissect the mass to be introduced. This route allows the dissection of the rectum and surrounding tissue until the abdominal cavity is reached, a wholly innovative technique.

This landmark surgery, presented simultaneously today in the Hospital Clinic of Barcelona and Massachusetts General Hospital, was made possible due to the experience of the two surgical teams, who both specialize in minimally-invasive surgical approaches to treat diseases of the colon and rectum.

In the future, this new technique will be available to treat other diseases of the colon and rectum.

Sources: Hospital Clinic of Barcelona, Massachusetts General Hospital