IRIS U kit usefulness in transanal total mesorectal excision for lower rectal cancer to avoid urethral injury

BMC Gastroenterol. 2024 Jun 17;24(1):203. doi: 10.1186/s12876-024-03279-8.

Abstract

Transanal total mesorectal excision (taTME) has improved the laparoscopic dissection for rectal cancer in the narrow pelvis. Although taTME has more clinical benefits than laparoscopic surgery, such as a better view of the distal rectum and direct determination of distal resection margin, an intraoperative urethral injury could occur in excision ta-TME. This study aimed to determine the feasibility and efficacy of the ta-TME with IRIS U kit surgery. This retrospective study enrolled 10 rectal cancer patients who underwent a taTME with an IRIS U kit. The study endpoints were the safety of access (intra- or postoperative morbidity). The detectability of the IRIS U kit catheter was investigated by using a laparoscope-ICG fluorescence camera system. Their mean age was 71.4±6.4 (58-78) years; 80 were men, and 2 were women. The mean operative time was 534.6 ± 94.5 min. The coloanal anastomosis was performed in 80%, and 20% underwent abdominal peritoneal resection. Two patients encountered postoperative complications graded as Clavien-Dindo grade 2. The transanal approach with IRIS U kit assistance is feasible, safe for patients with lower rectal cancer, and may prevent intraoperative urethral injury.

Keywords: IRIS U kit; Rectal cancer; Transanal; Urethral injury.

MeSH terms

  • Aged
  • Anastomosis, Surgical / adverse effects
  • Anastomosis, Surgical / methods
  • Feasibility Studies*
  • Female
  • Humans
  • Intraoperative Complications / etiology
  • Intraoperative Complications / prevention & control
  • Laparoscopy / adverse effects
  • Laparoscopy / methods
  • Male
  • Middle Aged
  • Operative Time
  • Postoperative Complications* / etiology
  • Postoperative Complications* / prevention & control
  • Proctectomy / adverse effects
  • Proctectomy / methods
  • Rectal Neoplasms* / surgery
  • Rectum / surgery
  • Retrospective Studies
  • Transanal Endoscopic Surgery* / adverse effects
  • Transanal Endoscopic Surgery* / methods
  • Urethra* / injuries
  • Urethra* / surgery