Department of Gastrointestinal Surgery, Institute of Digestive and Metabolic Diseases, Hospital Clínic, IDIBAPS, Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas, Centro Esther Koplowitz, University of Barcelona, Barcelona, Spain.
Colorectal Dis. 2011 Nov;13 Suppl 7:43-6. doi: 10.1111/j.1463-1318.2011.02781.x.
Surgical treatment has been in constant evolution in the search for minimizing incisions regardless of the complexity of the operation. Natural Orifice Translumenal Endoscopic Surgery (NOTES) represents this progression of surgery to less invasive procedures. Transanal endoscopic microsurgery (TEM) is an ideal NOTES platform to access the peritoneal cavity endoscopically through the anus and specifically to allow colorectal resections be performed through smaller, or indeed without, abdominal incisions. Transanal rectosigmoidectomy with total mesorectal excision (TME) using TEM is a feasible and oncologically safe option. Such use of currently available combined hybrid laparoendoscopic systems provides a safe platform to define future clinical applications and advantages of NOTES. Furthermore, it stimulates the active development of technologies that will support and enable it.
手术治疗一直在不断发展，寻求在不影响手术复杂性的情况下尽量减少切口。经自然腔道内镜外科（NOTES）代表了手术向微创程序的发展。经肛门内镜微创手术（TEM）是通过肛门进入腹腔的理想 NOTES 平台，特别是可以通过更小的切口，甚至无需腹部切口来完成结直肠切除术。TEM 行经肛门直肠乙状结肠切除术和全直肠系膜切除术（TME）是一种可行且具有肿瘤安全性的选择。目前使用的联合腹腔镜内镜混合系统的这种用途为定义 NOTES 的未来临床应用和优势提供了一个安全的平台。此外，它还刺激了支持和实现这一目标的技术的积极发展。
