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Figure 6. Overlapping sealing technique. Using of energy device instead of Hemo-loc or clip is beneficial to save time and reduce possible
complications related with Hemo-loc or clip. “Overlapping sealing technique” may increase security. IMA: inferior mesenteric artery
A
B
C
Figure 7. Specimen and post-OP abdominal view. Even though a large-scale operation produces a bulky specimen, there is absolutely
no visible operative incision or wound. Circles indicate Ascending colon cancer (A), Sigmoid colon ca (B), and Rectal cancer lesions
respectively (C)
to be a reasonable advantage as it not only saves time but also reduces complications that can occur during
entry and exit [Figure 6].
Reported case: transanal total proctocolectomy with IPAA
In February 2017, we performed transanal total proctocolectomy with IPAA without abdominal assistance in
[12]
patients with triple colorectal cancers (ascending, sigmoid colon, and rectum) using pure NOTES [Figure 7].
Case summary
A 70-year-old male patient without specific medical history was diagnosed with synchronous triple
colorectal cancers (ascending colon, rectosigmoid colon, and rectum). We performed transanal total
