Robotic Abdominal Unassisted Incision for Transvaginal Removal of Specimen in ERAS Mode for Radical Treatment of High Rectal Cancer (CRC-NOSES V)

经自然腔道取标本手术(NOSES)，相比传统腹部辅助切口取标本手术，具有术后腹壁损伤更小，美观效果好，术后恢复快，术后疼痛值低等优势，也因此被认为是“微创中的微创”，是微创外科的更进一步发展。加速康复外科(ERAS)旨是通过优化围手术期管理，从而促进术后康复。ERAS理念最早由黎介寿院士引入国内，并应用于结直肠手术中，现已被各个科室广泛应用于临床实际中。达·芬奇(Da Vinci)机器人手术不仅能保证术野范围以及清晰度，而且操作具有较高的灵活性和稳定性，其临床疗效也得到国内外广泛认可，因此也正成为结直肠微创外科的发展趋势。然而，我国经阴道NOSES术的开展现状远不如经直肠NOSES，本文介绍一例高位直肠癌应用NOSES (V式)手术方式经阴道取出标本病例。Compared with the traditional abdominal assisted incision for specimen collection, the natural orifice specimen extraction surgery (NOSES) has the advantages of less postoperative damage to the abdominal wall, better aesthetics, quicker postoperative recovery, and lower postoperative pain value, and therefore is considered the “minimally invasive of minimally invasive”, and is a further development of minimally invasive surgery. The enhanced recovery after surgery (ERAS) concept was first introduced in China by Academician Jieshou Li and applied to colorectal surgery, and is now widely used in clinical practice by various departments. DaVinci robotic surgery is becoming the trend in minimally invasive colorectal surgery, as it not only ensures the scope and clarity of the surgical field, but also provides high flexibility and stability in operation, and its clinical efficacy has been widely recognized at home and abroad. However, the current status of transvaginal NOSES in China is much lower than transrectal NOSES. This paper presents a case of high grade rectal cancer applying NOSES (V) surgical approach for transvaginal removal of specimen.