Laparoscopic Transvaginal Hybrid Anterior Resection: a Prospective Data Collection
Transvaginal hybrid procedures are of interest as an available NOTES-Procedure for the clinical routine. Few authors have demonstrated the feasibility and safety of such procedures (e.g. cholecystectomy) in selected patient collectives. In 2008 Lacy at al. published the experience with a transvaginal sigmoidectomy as a first in human report. The aim of this prospective data collection is to evaluate the feasibility and safety of the transvaginal hybrid anterior resection in the clinical routine.
Therefore all patients giving the informed consent to the transvaginal hybrid anterior resection will be included and assessed concerning feasibility to perform the transvaginal approach and complete the operation transvaginally.
|Sigmoid Diverticulitis (Hinchey I and II) Sigmoid Diverticulosis With Two or More Attacks of Diverticulitis||Procedure: Laparoscopic transvaginal hybrid anterior resection|
|Study Design:||Observational Model: Cohort
Time Perspective: Prospective
- Feasibility and safety of the transvaginal operation [ Time Frame: 30 days ]
- Long-term life quality and sexual dysfunction [ Time Frame: 3 year ]
|Study Start Date:||September 2008|
|Study Completion Date:||November 2010|
|Primary Completion Date:||November 2010 (Final data collection date for primary outcome measure)|
|Ginven indication for laparoscopic anterior resection||
Procedure: Laparoscopic transvaginal hybrid anterior resection
Transvaginal Hybrid Anterior Resection: three 5mm trocars are placed transabdominally (one trans-umbilical, the other two in the lower abdomen). Identification of the inferior mesenteric vein and artery. Clipping of the vein. Then placement of a 12mm trocar through the posterior fornix of the vagina for stapling of the inferior mesenteric artery. After mobilisation of the colon descendens and the splenic flexure stapling of the proximal rectum through the 12mm trocar placed vaginally. Afterwards the colpotomy is performed and the mobilised left hemi-colon is extracted transvaginally. The proximal colonic resection is performed extracorporeally in the conventional fashion with placement of a purse-string suture and insertion of the circular stapling anvil into the proximal end of the bowel. The bowel is then replaced into the abdominal cavity. The colpotomy is then closed. A circular stapler is inserted transanally and the end-to-end anastomosis is performed.
Please refer to this study by its ClinicalTrials.gov identifier: NCT01043731
|Department of surgery|
|St. Gallen, Switzerland, 9007|
|Principal Investigator:||Andreas Zerz, MD||Cantonal Hospital St. Gallen|