Transanal access port (TrAAP) technique: the use of a single incision laparoscopic surgical port during canine colonoscopy (a cadaveric study)

Abstract

Background: Transanal colonoscopy using the single-incision laparoscopic surgical port is routinely used in human patients but has not been described in veterinary literature. The purpose of this study was to describe a novel access technique elucidating its endoscopic clinical potential and benefits. Additionally, its challenges, limitations, and clinical usability will be discussed and critiqued. The aim of this study was to describe the feasibility of the single-incision laparoscopic surgical port (SILS) as a transanal access technique in canine cadavers and compare its technical capabilities and economic value when compared to the traditional approaches of digital pressure and purse string. Results: The overall time to reach an intraluminal pressure of 10 mmHg was faster for digital pressure versus purse string (p = 0.05) and faster for single-incision laparoscopic surgical port versus purse string (p < 0.02). Maximum luminal pressure was significantly higher between single-incision laparoscopic surgical port and purse string (p = 0.001). Mean pressure for both the complete 60 s trial and during the last 45 s of insufflation were highest with the SILS port and were significantly different between the single-incision laparoscopic surgical port versus purse string (p = 0.0001, p < 0.0001) and digital pressure versus purse string (p < 0.005, p < 0.01) respectively. Complete luminal distention and visualization was observed in all trials. Conclusions: The SILS port in a cadaveric canine model allowed good visualization of the rectal and colonic mucosa, provided constant insufflation of the colon and was feasible and subjectively easy to perform. Technical differences between techniques were observed with the use of the SILS port allowing for potentially lower personnel requirements, less procedural associated cost, less variability versus the digital pressure technique between assistants, and the ability of additional instruments to be used for procedures.