Surgical Endoscopy Unit, Department of Surgical and Gastroenterological Sciences, University of Padova, Padova, Italy.
Surg Endosc. 2011 Sep;25(9):3022-7. doi: 10.1007/s00464-011-1664-7. Epub 2011 Apr 12.
Natural orifice transluminal endoscopic surgery (NOTES), a new frontier of minimally invasive surgery, uses the body's natural orifices to create an access for surgical procedures. This study aimed to verify the technical feasibility of ileorectal bypass performed entirely through a transanal access.
The procedure was performed on 10 domestic pigs, after which they were killed. A transanal endoscopic microsurgery (TEM) device and endoscopic and laparoscopic instruments were used.
The findings demonstrated that an ileorectal bypass through a transanal access is feasible. The principal steps of a standardized transanal procedure are as follows: confirm a rectal perforation above the peritoneal reflection, perform peritoneoscopy using a standard gastroscope, grasp the small bowel with retrieval forceps and pull it through the rectal hole, suture the ileum and the rectum together using a TEM device, open the ileal loop, and perform endoscopic exploration. Satisfactory anastomosis and no signs of procedure-related complications were confirmed by a post procedure laparotomy.
Ileorectal bypass through a transanal access is technically feasible in a porcine model, and although still at an experimental stage, it could become a surgical option for treating some types of colonic strictures.
经自然腔道内镜手术（NOTES）是微创外科的一个新领域，利用人体的自然腔道进行手术操作。本研究旨在验证经肛门入路完全进行回肠直肠旁路术的技术可行性。
该手术在 10 只国内猪中进行，之后将其处死。使用经肛门内镜微创手术（TEM）设备和内镜及腹腔镜器械。
研究结果表明，经肛门入路进行回肠直肠旁路术是可行的。标准化经肛门手术的主要步骤如下：确认直肠穿孔位于腹膜反射之上，使用标准胃镜进行腹腔镜检查，用取物钳抓住小肠并将其从直肠孔中拉出，使用 TEM 设备将回肠和直肠缝合在一起，打开回肠袢，并进行内镜探查。剖腹探查证实吻合满意，无与手术相关的并发症迹象。
在猪模型中，经肛门入路进行回肠直肠旁路术在技术上是可行的，尽管仍处于实验阶段，但它可能成为治疗某些类型结肠狭窄的一种手术选择。
