The video shows the clamp rescue technique in Rectal cancer with the operation of bisphincterectomy. The difficulty and detail of the operation can be seen when detaching the intestine from the sphincter in order to avoid its injury.
The technique of bisphincterectomy opened new horizons in saving the sphincter and avoiding permanent colostomy in very low rectal cancers.
Bisphincteric resection (also known as inter-sphincteric resection, ISR) is a specialized surgical technique applied in selected cases of rectal cancer, mainly when the tumor is located very close to the anal sphincter, but without having invaded it directly.
Definition:
Bisphincterectomy involves removal of the terminal part of the rectum, along with part of the inner layer of the sphincter (internal sphincter), while preserving the external sphincter and thus continence. The purpose of the operation is the radical excision of the tumor and the preservation of the anus, avoiding a permanent colostomy (artificial bowel exit in the abdomen).
Indications:
- Very low-grade rectal cancer (≤ 2-3 cm from the serrated line)
- Stage T1-T2 or selected T3 tumor without invasion of the external sphincter or pelvic muscles
- Good general condition of patient and sphincter (no incontinence)
- Patient consent for possible postoperative change in stool quality