Laparoscopic surgery using a Gigli wire saw for locally recurrent rectal cancer with concomitant intraperitoneal sacrectomy

Mamoru Uemura, Masataka Ikeda, Kenji Kawai, Junichi Nishimura, Ichiro Takemasa, Tsunekazu Mizushima, Hirofumi Yamamoto, Mitsugu Sekimoto, Yuichiro Doki, Masaki Mori

Research output: Contribution to journalArticle

Abstract

MATERIALS AND SURGICAL TECHNIQUE: A 64-year-old man presented with LRRC on the surface of the sacral bone. He underwent laparoscopic abdominoperineal resection with concomitant sacrectomy below the S4 vertebra. The surgical procedure, including sacrectomy, was performed laparoscopically. The distance between the estimated resection line (below the S4 vertebra) and sacral promontory was measured by preoperative imaging. Intraoperatively, a flexible ruler was employed to determine the resection line. Securing adequate space dorsal to the sacral bone was indispensable for placement of the Gigli wire saw. After the Gigli wire saw was positioned, bilateral caudal trocars were used to remove the ends of the wire. Then, the sacral bone was cut by the linear reciprocating motion of the Gigli wire saw. Pathologically confirmed curative resection was achieved. The procedure was successfully performed without transfusion or intraoperative complications. The operation time was 757 min, and blood loss volume was 890 ml. There were no severe postoperative complications. The patient is alive and well with no evidence of recurrence at 58 months after surgical resection of LRRC.

DISCUSSION: Our newly developed technique demonstrates that laparoscopic intraperitoneal sacrectomy using a Gigli wire saw is a safe and useful procedure to facilitate resection of LRRC.

INTRODUCTION: Previous reports indicated the effectiveness of surgical resection for locally recurrent rectal cancer (LRRC). Most cases with posterior invasion patterns require concomitant sacrectomy to secure negative histologic margins, although this is a highly invasive procedure. Here, we present a new minimally invasive laparoscopic surgical technique for LRRC with concomitant sacrectomy.

Original languageEnglish
Pages (from-to)83-86
Number of pages4
JournalAsian journal of endoscopic surgery
Volume11
Issue number1
DOIs
Publication statusPublished - Feb 1 2018
Externally publishedYes

Fingerprint

Rectal Neoplasms
Laparoscopy
Bone and Bones
Spine
Intraoperative Complications
Blood Volume
Surgical Instruments
Recurrence

All Science Journal Classification (ASJC) codes

  • Medicine(all)

Cite this

Laparoscopic surgery using a Gigli wire saw for locally recurrent rectal cancer with concomitant intraperitoneal sacrectomy. / Uemura, Mamoru; Ikeda, Masataka; Kawai, Kenji; Nishimura, Junichi; Takemasa, Ichiro; Mizushima, Tsunekazu; Yamamoto, Hirofumi; Sekimoto, Mitsugu; Doki, Yuichiro; Mori, Masaki.

In: Asian journal of endoscopic surgery, Vol. 11, No. 1, 01.02.2018, p. 83-86.

Research output: Contribution to journalArticle

Uemura, M, Ikeda, M, Kawai, K, Nishimura, J, Takemasa, I, Mizushima, T, Yamamoto, H, Sekimoto, M, Doki, Y & Mori, M 2018, 'Laparoscopic surgery using a Gigli wire saw for locally recurrent rectal cancer with concomitant intraperitoneal sacrectomy', Asian journal of endoscopic surgery, vol. 11, no. 1, pp. 83-86. https://doi.org/10.1111/ases.12407
Uemura, Mamoru ; Ikeda, Masataka ; Kawai, Kenji ; Nishimura, Junichi ; Takemasa, Ichiro ; Mizushima, Tsunekazu ; Yamamoto, Hirofumi ; Sekimoto, Mitsugu ; Doki, Yuichiro ; Mori, Masaki. / Laparoscopic surgery using a Gigli wire saw for locally recurrent rectal cancer with concomitant intraperitoneal sacrectomy. In: Asian journal of endoscopic surgery. 2018 ; Vol. 11, No. 1. pp. 83-86.
@article{3f2359a6169f448e97a643690302b6f9,
title = "Laparoscopic surgery using a Gigli wire saw for locally recurrent rectal cancer with concomitant intraperitoneal sacrectomy",
abstract = "MATERIALS AND SURGICAL TECHNIQUE: A 64-year-old man presented with LRRC on the surface of the sacral bone. He underwent laparoscopic abdominoperineal resection with concomitant sacrectomy below the S4 vertebra. The surgical procedure, including sacrectomy, was performed laparoscopically. The distance between the estimated resection line (below the S4 vertebra) and sacral promontory was measured by preoperative imaging. Intraoperatively, a flexible ruler was employed to determine the resection line. Securing adequate space dorsal to the sacral bone was indispensable for placement of the Gigli wire saw. After the Gigli wire saw was positioned, bilateral caudal trocars were used to remove the ends of the wire. Then, the sacral bone was cut by the linear reciprocating motion of the Gigli wire saw. Pathologically confirmed curative resection was achieved. The procedure was successfully performed without transfusion or intraoperative complications. The operation time was 757 min, and blood loss volume was 890 ml. There were no severe postoperative complications. The patient is alive and well with no evidence of recurrence at 58 months after surgical resection of LRRC.DISCUSSION: Our newly developed technique demonstrates that laparoscopic intraperitoneal sacrectomy using a Gigli wire saw is a safe and useful procedure to facilitate resection of LRRC.INTRODUCTION: Previous reports indicated the effectiveness of surgical resection for locally recurrent rectal cancer (LRRC). Most cases with posterior invasion patterns require concomitant sacrectomy to secure negative histologic margins, although this is a highly invasive procedure. Here, we present a new minimally invasive laparoscopic surgical technique for LRRC with concomitant sacrectomy.",
author = "Mamoru Uemura and Masataka Ikeda and Kenji Kawai and Junichi Nishimura and Ichiro Takemasa and Tsunekazu Mizushima and Hirofumi Yamamoto and Mitsugu Sekimoto and Yuichiro Doki and Masaki Mori",
year = "2018",
month = "2",
day = "1",
doi = "10.1111/ases.12407",
language = "English",
volume = "11",
pages = "83--86",
journal = "Asian journal of endoscopic surgery",
issn = "1758-5902",
publisher = "Wiley Blackwell",
number = "1",

}

TY - JOUR

T1 - Laparoscopic surgery using a Gigli wire saw for locally recurrent rectal cancer with concomitant intraperitoneal sacrectomy

AU - Uemura, Mamoru

AU - Ikeda, Masataka

AU - Kawai, Kenji

AU - Nishimura, Junichi

AU - Takemasa, Ichiro

AU - Mizushima, Tsunekazu

AU - Yamamoto, Hirofumi

AU - Sekimoto, Mitsugu

AU - Doki, Yuichiro

AU - Mori, Masaki

PY - 2018/2/1

Y1 - 2018/2/1

N2 - MATERIALS AND SURGICAL TECHNIQUE: A 64-year-old man presented with LRRC on the surface of the sacral bone. He underwent laparoscopic abdominoperineal resection with concomitant sacrectomy below the S4 vertebra. The surgical procedure, including sacrectomy, was performed laparoscopically. The distance between the estimated resection line (below the S4 vertebra) and sacral promontory was measured by preoperative imaging. Intraoperatively, a flexible ruler was employed to determine the resection line. Securing adequate space dorsal to the sacral bone was indispensable for placement of the Gigli wire saw. After the Gigli wire saw was positioned, bilateral caudal trocars were used to remove the ends of the wire. Then, the sacral bone was cut by the linear reciprocating motion of the Gigli wire saw. Pathologically confirmed curative resection was achieved. The procedure was successfully performed without transfusion or intraoperative complications. The operation time was 757 min, and blood loss volume was 890 ml. There were no severe postoperative complications. The patient is alive and well with no evidence of recurrence at 58 months after surgical resection of LRRC.DISCUSSION: Our newly developed technique demonstrates that laparoscopic intraperitoneal sacrectomy using a Gigli wire saw is a safe and useful procedure to facilitate resection of LRRC.INTRODUCTION: Previous reports indicated the effectiveness of surgical resection for locally recurrent rectal cancer (LRRC). Most cases with posterior invasion patterns require concomitant sacrectomy to secure negative histologic margins, although this is a highly invasive procedure. Here, we present a new minimally invasive laparoscopic surgical technique for LRRC with concomitant sacrectomy.

AB - MATERIALS AND SURGICAL TECHNIQUE: A 64-year-old man presented with LRRC on the surface of the sacral bone. He underwent laparoscopic abdominoperineal resection with concomitant sacrectomy below the S4 vertebra. The surgical procedure, including sacrectomy, was performed laparoscopically. The distance between the estimated resection line (below the S4 vertebra) and sacral promontory was measured by preoperative imaging. Intraoperatively, a flexible ruler was employed to determine the resection line. Securing adequate space dorsal to the sacral bone was indispensable for placement of the Gigli wire saw. After the Gigli wire saw was positioned, bilateral caudal trocars were used to remove the ends of the wire. Then, the sacral bone was cut by the linear reciprocating motion of the Gigli wire saw. Pathologically confirmed curative resection was achieved. The procedure was successfully performed without transfusion or intraoperative complications. The operation time was 757 min, and blood loss volume was 890 ml. There were no severe postoperative complications. The patient is alive and well with no evidence of recurrence at 58 months after surgical resection of LRRC.DISCUSSION: Our newly developed technique demonstrates that laparoscopic intraperitoneal sacrectomy using a Gigli wire saw is a safe and useful procedure to facilitate resection of LRRC.INTRODUCTION: Previous reports indicated the effectiveness of surgical resection for locally recurrent rectal cancer (LRRC). Most cases with posterior invasion patterns require concomitant sacrectomy to secure negative histologic margins, although this is a highly invasive procedure. Here, we present a new minimally invasive laparoscopic surgical technique for LRRC with concomitant sacrectomy.

UR - http://www.scopus.com/inward/record.url?scp=85053123323&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85053123323&partnerID=8YFLogxK

U2 - 10.1111/ases.12407

DO - 10.1111/ases.12407

M3 - Article

C2 - 29485249

AN - SCOPUS:85053123323

VL - 11

SP - 83

EP - 86

JO - Asian journal of endoscopic surgery

JF - Asian journal of endoscopic surgery

SN - 1758-5902

IS - 1

ER -