Laparoscopic total colectomy with natural orifice specimen extraction current status until 2022: a scoping review

Gundogan E., Gokler C., Sansal M.

Annals of Laparoscopic and Endoscopic Surgery, vol.7, 2022 (ESCI) identifier identifier

  • Publication Type: Article / Review
  • Volume: 7
  • Publication Date: 2022
  • Doi Number: 10.21037/ales-22-20
  • Journal Name: Annals of Laparoscopic and Endoscopic Surgery
  • Journal Indexes: Emerging Sources Citation Index (ESCI), Scopus
  • Keywords: Minimally invasive surgery, laparoscopic colorectal, transanal, transvaginal, subtotal colon resection, ILEORECTAL ANASTOMOSIS, COLON
  • Kayseri University Affiliated: No


© Annals of Laparoscopic and Endoscopic Surgery. All rights reserved.Background: Natural orifice surgery is used to minimize incision-related complications in colorectal surgery. Less pain, higher aesthetic score and higher patient comfort are aimed in this respect. Segmental colon resections were followed by total colon resections, but the process did not gain momentum like other resections. Methods: Review of the literatüre electronic searches of the PubMed/Medline and Google Scholar databases were carried out on 14 May 2022 using the key words (transvaginal OR transanal OR transrectal) AND ((colon OR colonic) AND (resection OR resections) OR colectomy) AND (total OR subtotal). Data for publication year, country, patient gender, age, surgical indication, natural orifice for extraction, duration of surgery, blood loss, type of ileo rectal anastomosis, morbidity, length of hospital stay, and follow-up time were recorded. Results: A total of 14 related and 71 patients were found in these studies. Publications which started in 2008, did not receive sufficient attention until 2018, it was later seen that there was an increase in the number of publications reported after 2018. Although benign diseases and early stage cancers constituted the patient population, it was observed that no significant gender differences were reported. In previous studies, it was reported that the transanal route (90%) was used predominantly and end-to-end anastomosis (59%) was the most preferred method. Although the complication rates were 20%, the necessity of reoperation was 6%. Conclusions: Although more objective results can be found with studies with large patient participation, the combination of total colectomy and natural orifice specimen extraction (NOSE) seems to be a technique that can increase patient comfort in suitable patients.