A Review of the Role of Natural Orifice Specimen Extraction Surgery in Laparoscopic Colorectal Surgery

Document Type : Review Article

Authors

1 Colorectal Surgeon at Hospital das Clínicas; Associate Professor of Surgery at University of São Paulo Medical School (USP), Brazil

2 Post-Doctoral Research Fellow of Colorectal Surgery at Adventure Health Central Florida, Sanford, Florida, USA

3 Colorectal Surgeon in Gastroclínica Cascavel (Cascavel, Paraná), Brazil

4 Colorectal Surgeon, at University of Campinas (UNICAMP) and São Francisco University (USF) at Bragança Paulista. São Paulo, Brazil

Abstract

The inclusion of minimally invasive techniques in colorectal surgery brought many advantages to patient’s
recovery. However, conventional techniques for laparoscopic-assisted colectomy (LAC) still require a small
abdominal incision for specimen extraction. The present manuscript aimed to review the technical details,
results, and advantages of colorectal resections using different approaches to extract the resected specimen,
including the abdominal wall, the vagina, or the rectum. To analyze this data, we searched the literature for
recent and important results concerning the use of different approaches to extract the specimen in minimally
invasive colorectal procedures. Besides the proven feasibility and safety associated with Natural Orifice
Specimen Extraction Surgery (NOSES) in colorectal surgery, some unresolved issues remain to be unified and
standardized. These issues are mainly represented by surgical techniques and indications. Morbidity is not a
common problem, although potentially there may be complications affecting the quality of life. So far, the most
important indication remains the management of intestinal endometriosis, as it is not a malignant disease and
the specimen is not too large. Nevertheless, surgical experience and appropriate counseling are fundamental
requirements when dealing with cancer patients. Eventual complications should be discussed with patients.

Keywords

References

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Iranian Journal of Colorectal Research
Volume 12, Issue 1
March 2024
Pages 16-22

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