RT Journal Article
SR Electronic
T1 Minimally invasive approach to low-velocity penetrating extraperitoneal rectal trauma
JF Trauma Surgery & Acute Care Open
JO Trauma Surg Acute Care Open
FD BMJ Publishing Group Ltd
SP e000396
DO 10.1136/tsaco-2019-000396
VO 5
IS 1
A1 Megan Melland-Smith
A1 Tyler R Chesney
A1 Shady Ashamalla
A1 Fred Brenneman
YR 2020
UL http://tsaco.bmj.com/content/5/1/e000396.abstract
AB Unlike intraperitoneal colorectal injuries, the standard of care for extraperitoneal rectal trauma includes a diverting colostomy due to relative inaccessibility of these injuries for primary repair. New technologies to enhance access to the extraperitoneal rectum have gained increasing use in benign and malignant rectal disease. We present two cases of low-velocity penetrating extraperitoneal rectal trauma. In both cases, a transanal minimally invasive surgery (TAMIS) approach was used to access, and primarily repair, full-thickness rectal lacerations. These patients were successfully managed without a colostomy and without complication. TAMIS enables access to distal rectal injuries, facilitating primary repair and bringing the management of extraperitoneal rectal injuries in line with intraperitoneal injuries, with the potential to avoid fecal diversion.