Evaluation of transanal minimally invasive surgery for submucosal rectal resection in cadaveric canine specimens

AbstractObjectiveTo evaluate the feasibility of transanal minimally invasive surgery (TAMIS) for submucosal rectal resection in large breed dogs.Study designCadaveric study.Sample populationCanine cadavers (n = 6) weighing between 37.5 and 60 kg.MethodsDogs were positioned in sternal recumbency. After rectal cleansing, a transanal access platform was placed in the rectum, and a pneumorectum was established. An area of ventral rectal wall approximately 2 × 2 cm was resected in a submucosal plane by using laparoscopic instruments and submitted for histopathological evaluation. The rectal wall defect was closed with a single‐layer continuous suture pattern with barbed suture. Postoperatively, the rectum was removed en bloc and evaluated for suture or surgical penetration of the serosal surface.ResultsSubmucosal rectal resection was successfully completed by using TAMIS in all dogs. The median length of resected specimens after fixation was 24.5 mm (range 9.8‐26.5). In two of six dogs, suture was macroscopically visible on the serosal surface, but no dogs had evidence of iatrogenic full‐thickness surgical penetration of the rectum. The median distance from the aborad extent of the suture closure line to the anocutaneous junction was 35 mm (range, 35‐105).ConclusionSubmucosal resection of the canine rectal wall was feasible in large breed dogs by using TAMIS. No evidence of full‐thickness penetration of the rectal wall was seen in these cadaveric specimens.Clinical significanceTransanal minimally invasive surgery may provide an alternative minimally invasive approach for resection for benign adenomatous rectal polyps in large breed dogs that might otherwise require a rectal pull‐through.