Introduction: Transanal endoscopic microsurgery (TEM) is widely used for the excision of both benign and malignant rectal tumours. It is relatively expensive and can be a challenging technique. A recent development in laparoscopic surgery is the single-port technique (single-incision laparoscopic surgery, SILS). The SILS port is a flexible multichannel port for transumbilical laparoscopic surgery. Even though not developed for transanal use the port could be ideal because of its shape and texture. Methods: 12 patients underwent transanal resection using an SILS port and normal laparoscopic instruments. Results: 10 out of 12 patients were treated successfully with the SILS port. Two polyps were resected using an open transanal technique because the distance between the SILS port and the polyp was too small. The average operative time was 55 min (range 40–80 min). All patients could be discharged on the first postoperative day. There were no major complications. Conclusion: Our current data show that transanal surgery using a single port is a relatively easy procedure with operative times comparable to TEM. More surgeons will therefore be able to perform transanal endoscopic surgery.

1.
Middleton PF, Sutherland LM, Maddern GJ: Transanal endoscopic microsurgery: a systematic review. Dis Colon Rectum 2005;48:270–284.
2.
De Graaf EJ, Doornebosch PG, Tetteroo GW, Geldof H, Hop WC: Transanal endoscopic microsurgery is feasible for adenomas throughout the entire rectum: a prospective study. Dis Colon Rectum 2009;52:1107–1113.
3.
Doornebosch PG, Gosselink MP, Neijenhuis PA, Schouten WR, Tollenaar RA, de Graaf EJ: Impact of transanal endoscopic microsurgery on functional outcome and quality of life. Int J Colorectal Dis 2008;23:709–713.
4.
Jin Z, Yin L, Xue L, Lin M, Zheng Q: Anorectal functional results after transanal endoscopic microsurgery in benign and early malignant tumors. World J Surg 2010;34:1128–1132.
5.
Cuesta MA, Berends F, Veenhof AA: The ‘invisible cholecystectomy’: a transumbilical laparoscopic operation without a scar. Surg Endosc 2008;22:1211–1213.
6.
Vestweber B, Alfes A, Paul C, Haaf F, Vestweber KH: Single-incision laparoscopic surgery: a promising approach to sigmoidectomy for diverticular disease. Surg Endosc 2010;24:3225–3228.
7.
van den Boezem PB, Sietses C: Single-incision laparoscopic colorectal surgery, experience with 50 consecutive cases. J Gastrointest Surg 2011, E-pub ahead of print.
8.
Buess G, Theiss R, Gunther M, et al: Endoscopic surgery in the rectum. Endoscopy 1985;17:31–35.
9.
Kalloo AN, Singh VK, Jagannath SB, Niiyama H, Hill SL, Vaughn CA, Magee CA, Kantsevoy SV: Flexible transgastric peritoneoscopy: a novel approach to diagnostic and therapeutic interventions in the peritoneal cavity. Gastrointest Endosc 2004;60:114–117.
10.
Rao GV: Transgastric appendectomy results and follow-up (SAGES transgastric surgery panel), SAGES Meeting, Dallas, 2006.
11.
Khoo R: Transanal excision of a rectal adenoma using a single-access laparoscopic port. Dis Colon Rectum 2010;53:1078–1079.
12.
Lorenz C, Nimmesgern T, Back M, Langwieler T: Transanal single port microsurgery (TSPM) as a modified technique of transanal endoscopic microsurgery (TEM). Surg Innov 2010;17:160–163.
13.
Cid R, Pérez J, Elosua T, Pinto F, Alegre J, Martín R, Jiménez J: Transanal resection using a single port trocar: a new approach to NOTES. Cir Esp 2011;89:20–23.
14.
Sylla P, Rattner DW, Delgado S, Lacy AM: NOTES transanal rectal cancer resection using transanal endoscopic microsurgery and laparoscopic assistance. Surg Endosc 2010;24:1205–1210.
15.
Tuech JJ, Bridoux V, Kianifard B, Schwarz L, Tsilividis B, Huet E, Michot F: Natural orifice total mesorectal excision using transanal port and laparoscopic assistance. Eur J Surg Oncol 2011;37:334–335.
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
You do not currently have access to this content.