Transanal Single Port Microsurgery (TSPM) as a Modified Technique of Transanal Endoscopic Microsurgery (TEM)

Background: Single port access (SPA) surgery is a new procedure for minimal invasive surgery using one multichannel port. The authors adapted this technique for transanal surgery as an improvement of the transanal endoscopic microsurgery (TEM). Methods: A total of 3 patients underwent SPA modified TEM using the SILS port (Covidien) under CO(2) insufflation. This port allows insertion of 2 laparoscopic instruments and a telescope. Results: The operation was completed successfully in all cases. The transanal placement of the SILS port was easy to perform; a prior dilatation of the anal sphincter was not necessary. There were no perioperative or postoperative complications as verified by postoperative observation, rectoscopy, and anal ultrasound. Conclusions: Transanal single port microsurgery is a feasible and new technique for less invasive and more gentle transanal surgery. By using this new multichannel device TEM surgery was changed in a modified way while preserving the anal sphincter.