title: Laparoscopic-assisted low and ultralow anterior resection for lower rectal cancer using the simple "Rectum Catcher" device and an intra-operative colonoscopy.
abstract: OBJECTIVE
  We report the feasible technique in lower rectal surgery.
  
  
  METHODS
  The Rectum Catcher (Matsumoto et al. in Surg Endosc 22:1905-1909, 2008) is made of stainless steel, with a circle of diameter 6 mm punched out at a distance of 5 mm from the top and covered with a short-cut T-tube. A vessel tape is inserted into the stainless steel and the short-cut T-tube. The rectum is grasped using the Rectum Catcher at a proximal rectum of the cancer, and the location of the cancer is confirmed using an intra-operative colonoscopy. In the next step, the Rectum Catcher is applied at the distal rectum of the cancer, and which easily occludes the rectum, and we confirm that the cancer is not at the distal rectum from the Rectum Catcher, using an intra-operative colonoscopy. The rectal lumen is irrigated. Then, the linear cutter is positioned just distal rectum to the Rectum Catcher, and the rectum is transected adequately.
  
  
  RESULTS
  From January 2009 to the present, this study included 18 patients undergoing laparoscopic-assisted low and ultralow anterior resection for lower rectal cancer, using the Rectum Catcher and an intra-operative colonoscopy. Using the Rectum Catcher and an intra-operative colonoscopy, we can easily make a decision of the location of rectal cancer in lower rectum and irrigation of rectal lumen can be easily performed to safely cut the bowel being occluded, in the narrow laparoscopic view of the pelvic cavity.
  
  
  CONCLUSIONS
  The combination between the Rectum Catcher and an intra-operative colonoscopy is useful for performing laparoscopic rectal surgery.
authors.affiliation: Department of Surgery, Tsuchiura Kyodo General Hospital, 11-7 Manabeshinmachi, Tsuchiura, 300-0053, Japan. ak-matsumoto@mti.biglobe.ne.jp
authors.forename: Akiyo
authors.initials: A
authors.lastname: Matsumoto
authors.forename: Kaida
authors.initials: K
authors.lastname: Arita
authors.forename: Masaki
authors.initials: M
authors.lastname: Tashiro
authors.forename: Shigeo
authors.initials: S
authors.lastname: Haruki
authors.forename: Shinsuke
authors.initials: S
authors.lastname: Usui
authors.forename: Susumu
authors.initials: S
authors.lastname: Hiranuma
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003113:Colonoscopy / Q000295:instrumentation*; D005260:Female; D006801:Humans; D007430:Intraoperative Care / Q000295:instrumentation*; D010535:Laparoscopy / Q000295:instrumentation* / Q000379:methods*; D008297:Male; D008875:Middle Aged; D012004:Rectal Neoplasms / Q000601:surgery*; D012007:Rectum / Q000601:surgery*; D013525:Surgical Instruments