TOTALLY ENDOSCOPIC COLORECTAL RESECTION LAPAROSCOPY-ASSISTED

Background: Laparoscopic colorectal resection for malignancy has proved its efficacity and safety when compared to “open” techniques. Even from an oncological point of view the two different approaches have similar results. Aim of this study is to verify the feasibility of a colorectal resection for malignancy in a totally endoscopic way under laparoscopic guidance, and to complete the procedure with a lymphadenectomy following the oncological principles. Objective of the device: On the basis of anatomical knowledges, of the performances of the present circular staplers and their potentiality, the new instrument should have the task to simplify the procedure and to make it less invasive when compared to conventional approaches, since an abdominal incision is avoided. Results: A new circular stapler was hypothetically conceived adding a “resection” function to anastomosis. Technical features of this instrument are the presence of two annular inflatable elements (on the anvil and the body of the stapler) and the capability “to store” the diseased intestinal wall inside the instrument body by means of a vacuum force. Conclusions: In the progression towards less invasive techniques in the treatment of colorectal malignancy, this approach seems to be the natural evolution of the process. Under verification of the feasibility of the technique, the potential advantages of this approach are enormous. Since the operation is performed in a totally endoscopic way, the opening of the intestinal lumen is avoided. As a consequence, two major advantages are present: no tumor cells “spillage”, and no risk of abdominal or wound infection by bacterial contamination.