Dr Aniqa Rahman, Dr. Tehreem Fatima, Dr Maryam Mumtaz
The aim of this study is to review the practicability and benefits of reduced port laparoscopic surgery with NOSES. Over the past years rectal cancer surgery has been advanced with the addition of different techniques to reduce the invasiveness with better outcome. Minimal invasive surgery is the finest addition in the treatment with reduced post-operative pain, less wound complication, earlier return of bowel function, less adhesions, better cosmetic and possibly shorter hospital stay. In conventional technique of Specimen extraction, we need “mini-laparotomy” which needs a long cut on the abdomen for the extraction of specimen which mask the benefits of laparoscopic surgery. Natural orifice specimen extraction (NOSE) is a better technique to overcome this shortcoming in which we extract the specimen through the hollow viscus that already communicates with the outside world such as anus or vagina. The notion of this procedure is to remove the specimen with decrease trauma required for the removal of specimen with better outcome such as reduced post-operative pain, less use of analgesics, early healing with less wound complications and most important the excellent cosmesis effect compared to conventional specimen extraction. While the feasibility of NOSE has been demonstrated but there are also some limitation of NOSE which effect the application of this technique in colorectal surgery. Certain factor like BMI, ASA Score, Specimen size, and gender are main factors for effectiveness of this technique. Keywords: Colorectal cancer surgery, natural orifice specimen extraction, rectum, feasibility of NOSE, colorectal, minimally invasive surgery.