Hybrid transanal endoscopic microsurgery: a novel approach to rectal neoplasm excision.

AIM: Rectal neoplasm excision is a challenging issue in gastrointestinal endoscopy and surgery. This technical note describes a hybrid method for the excision of challenging rectal neoplasms.

METHOD: The procedure consists of the combined use of classic endoscopy and transanal endoscopic microsurgical instrumentation for full-thickness removal of a recurrent rectal polyp in a patient who had previously undergone endoscopic excision of a Tis rectal adenocarcinoma, located behind the valve of Houston and 9 cm from the anal verge.

RESULTS

The lesion was removed completely in 50 min with no operative complication. The patient's postoperative course was uneventful, and she was discharged after 5 days. Pathological examination of the specimen confirmed complete resection of the lesion with adequate disease-free margins.

CONCLUSION

Hybrid transanal endoscopic microsurgery successfully combines the precision and flexibility of classic endoscopy with the radicality and safety of transanal endoscopic microsurgery for the treatment of demanding benign or early-stage malignant rectal tumours.