Abstract：
The purpose of this video is to demonstrate how to achieve adequate length and blood supply of the proximal colon for a perineal pull-through procedure, without splenic flexure mobilization during natural orifice specimen extraction. Key steps of the procedure include lateral mobilization of the colon, D3 lymph node dissection, preservation of the left colic artery, low ligation of the inferior mesenteric vein, ligation and washout of the distal bowel lumen, extra-abdominally proximal resection of sigmoid colon, purse-string sutures on the distal sigmoid colon, and an air leak test. Transluminal specimen extraction with extra-abdominal resection was found to be a cost-effective procedure with good cosmetic effects. Tension-free anastomosis was achieved by preservation of the left colic artery and low ligation of the inferior mesenteric vein. The purse-string sutures were placed on the proximal and distal bowel to avoid crossing the staples line. Transluminal specimen extraction with extra-abdominal resection required minimal manipulation intra-abdominally in comparison with other natural orifice specimen extraction techniques.
摘要：
本视频的目的是演示如何实现适当的长度和近端结肠的血液供应的会阴穿刺程序，在自然孔口标本提取过程中没有脾弯曲动员。该程序的关键步骤包括结肠的侧向动员，D3淋巴结清扫术，保留左绞痛动脉，肠系膜下静脉低位结扎，结扎并冲洗远端肠腔，乙状结肠腹外近端切除术，远端乙状结肠上的荷包缝线，还有漏气测试.经腹外切除的腔内标本提取被发现是一种具有良好美容效果的经济有效的方法。通过保留左绞痛动脉和肠系膜下静脉低位结扎实现无张力吻合。将荷包缝合线放置在近端和远端肠上，以避免交叉钉线。与其他自然孔口标本提取技术相比，腹外切除的腔内标本提取需要最少的腹内操作。
