ISMAİL ERTUGRUL
Southern Clinics of Istanbul Eurasia - 2024;35(4):301-305
Due to its advantages, minimally invasive surgery has become a standard treatment approach in many surgical operations today. To address the complications associated with enlarged wounds for specimen extraction after minimally invasive surgery, the natural orifice specimen extraction (NOSE) method has been developed, allowing specimens to be extracted through natural openings. In addition to the existing advantages of laparoscopy, this method significantly reduces the rates of postoperative pain, infection, and hernia development. Laparoscopic colectomy is frequently used in colorectal surgery. However, the specimen is typically extracted via mini-laparotomy. There are four potential approaches for extracting the specimen through natural openings after laparoscopic resection: transanal, transurethral, transoral, and transvaginal. In colorectal surgery, NOSE is generally categorized into two main approaches: the transanal and transvaginal routes, depending on the type of specimen extraction. Each of these methods has its own advantages and disadvantages. This article aims to provide information on the transanal and transvaginal methods used for specimen extraction through natural openings in laparoscopic colorectal surgery and to compare these two approaches. Although specimen extraction via natural openings is a complex surgical procedure, it offers potential advantages. However, it requires advanced laparoscopic expertise. The transanal route can be used safely, particularly for early-stage and small-scale tumors, while the transvaginal route can be safely applied in female patients with larger lesions.
