Laparoscopic Total Colectomy with Transvaginal Specimen Extraction (NOSES X)
Laparoscopic total colectomy is considered as one of the most advanced techniques involving a wide resection range and complex surgical procedures. Compared with conventional laparoscopic total colectomy, the main difference of NOSES X is the digestive tract reconstruction and the route of specimen extraction. The main procedures of NOSES X include complete laparoscopic total colectomy, transvaginal specimen extraction, and side-to-end anastomosis between the ileum and rectum. Compared with NOSES IX, the procedure of NOSES X has a wider indication because of the good ductility of the vagina. In addition, this technique reduces exposure of the bowel lumen within the abdominal cavity, which may reduce the chance of infection. The implementation of NOSES X requires the surgeon to have a solid anatomical basis and clear surgical ideas.