Laparoscopic Left Colon Cancer Resection with Transanal Specimen Extraction (NOSES VI)
The relative low incidence of left-sided colon cancer (only accounting for 5–6% of colon cancer), some accompanied by obstructive symptoms, leads to a lower volume of experience in NOSES VI. Compared with conventional laparoscopic left hemicolectomy, the main features of NOSES VI include that the total laparoscopic resection of left-sided colon, specimen extraction from the rectum and anus, and an anastomosis between the transverse colon and rectum are finished in the abdominal cavity. The operating difficulties of NOSES VI mainly involve the laparoscopic technical difficulties and the challenges of NOSES. Specifically the laparoscopic technical difficulties include the complete mesentery excision of left-sided colon, the extended lymph node dissection, as well as the separation of splenic colon. The NOSES technical difficulties include the extraction of the left-sided colon specimens, reconstruction of the digestive tract in the abdominal cavity, aseptic technique, and nontumor operation.