Natural orifice specimen extraction (NOSE) surgery with rectal eversion and total extra-abdominal resection.

Background: Natural orifice specimen extraction (NOSE)surgery is gaining popularity among colorectal surgeons. The technical aspects of this new procedure are still debated and many variations have been presented in the last decade.

Methods: We propose a new variation of transanal NOSE after robotic and laparoscopic LAR consisting of rectal eversion by using a special rod after laparoscopic TME.

Transperineal Excision of Rectal Gastrointestinal Stromal Tumor.

Gastrointestinal stromal tumors (GIST) of the rectum occur in approximately 4% of patients with rectal malignancies. Herein, we demonstrate a transperineal approach as a safe surgical technique for GISTs located anterior to the rectum. The proposed technique allows safe and effective excision of a tumor without disturbing the rectal anterior wall.

Laparoscopic technique of modified extraperitoneal (retrotransversalis) end colostomy for abdominoperineal excision.

Aim: To describe the technique of a modified extraperitoneal retrotransversalis end colostomy as part of a laparoscopic abdominoperineal excision (APR).

Method: The colostomy site is preoperatively chosen and used intra-operatively for a trocar. After the rectum has been mobilized the descending colon is freed.