Transcolonic natural orifice specimen extraction for laparoscopic radical right hemicolectomy on ascending colon cancer: one case report and literature review

This paper first reports the technical procedures by using colonoscope for transluminal specimen extraction after totally laparoscopic radical right hemicolectomy. The patient described herein was diagnosed with ascending colon cancer and underwent transcolonic natural orifice specimen extraction via colonoscope assistance without abdominal wall assisted incisions at Xiangya Hospital of Central South University in June 2019. The duration of surgery was 246 minutes, and the intraoperative blood loss was 20 mL. The specimen was removed through the left half of the transverse colon, splenic flexure of colon, descending colon, sigmoid colon, rectum and anus while preserving the tumor integrity. The patient recovered very well without any complications. After 6 months of follow-up, the patient was well healed, the anal exhaust and defecation functions of the patient were normal, and there was no pain reported in relation to the smaller abdominal trocar incisions. The aim of this study is to demonstrate that transcolonic natural orifice specimen extraction surgery (transcolonic NOSES) for laparoscopic radical right hemicolectomy on ascending colon cancer is feasible and this approach can achieve satisfactory clinical outcomes.