BACKGROUND: Our goal was to evaluate the feasibility of transrectal rigid hybrid natural orifice translumenal endoscopic surgery (NOTES) sigmoidectomy (trNS) in a series of consecutive prospective @entity1 with @entity66 . The NOTES for left colectomy offers @entity1 @entity158 and easier recovery. Limited data are available for trNS, which is considered safe for various indications. However, the technique is not standardized, and @entity1 in the reported series are highly selected. STUDY DESIGN: @entity1 scheduled for trNS were entered into a prospective registry on an intention-to-treat basis. The primary endpoint was trNS feasibility, and secondary endpoints were morbidity, @entity158 , length of stay, and inflammatory response. A medial-to-lateral dissection with full mobilization of the splenic flexure and total intracorporeal @entity254 was performed. The rectum was covered with a wound protector for transrectal extraction. RESULTS: Of 95 elective sigmoidectomies, 81% (n  = 77) were enrolled for either transvaginal NOTES resection (n  = 37) or trNS (n  = 40). There was no difference in body mass index or indication between @entity1 undergoing laparoscopic-assisted sigmoidectomy (LAS), transvaginal resection, or trNS, although trNS @entity1 were younger. Mainly because of a mismatch of bulky specimen and narrow pelvis, 17.5% of trNS were converted to LAS. Major morbidity was 10%, including 2 septic complications. During the study, the @entity254 technique was changed from double stapled end-to-end to side-to-end @entity254 . CONCLUSIONS: Transrectal rigid hybrid natural orifice translumenal endoscopic sigmoidectomy is feasible and safe in a high proportion of unselected consecutive @entity1 with @entity66 undergoing elective treatment. Intracorporeal side-to-end @entity254 is the preferred technique, and trNS should be offered for elective sigmoidectomy presupposing advanced laparoscopic experience.

Transrectal Rigid-Hybrid Natural Orifice Translumenal Endoscopic Sigmoidectomy for  XXXX : A Prospective Cohort Study.

@entity1 :: ('9606', 'Species') :: ['Patients', 'patients'] @entity254 :: ('MESH:C563598', 'Disease') :: ['anastomosis'] @entity66 :: ('MESH:D004194', 'Disease') :: ['diverticular disease'] @entity158 :: ('MESH:D010146', 'Disease') :: ['reduced pain', 'pain']
@entity66 :: (MESH:D004194,Disease) :: ['Diverticular Disease']
