{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,27]],"date-time":"2026-05-27T23:47:24Z","timestamp":1779925644889,"version":"3.53.1"},"reference-count":18,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2024,6,17]],"date-time":"2024-06-17T00:00:00Z","timestamp":1718582400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2024,6,17]],"date-time":"2024-06-17T00:00:00Z","timestamp":1718582400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Gastroenterol"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Transanal total mesorectal excision (taTME) has improved the laparoscopic dissection for rectal cancer in the narrow pelvis. Although taTME has more clinical benefits than laparoscopic surgery, such as a better view of the distal rectum and direct determination of distal resection margin, an intraoperative urethral injury could occur in excision ta-TME. This study aimed to determine the feasibility and efficacy of the ta-TME with IRIS U kit surgery. This retrospective study enrolled 10 rectal cancer patients who underwent a taTME with an IRIS U kit. The study endpoints were the safety of access (intra- or postoperative morbidity). The detectability of the IRIS U kit catheter was investigated by using a laparoscope-ICG fluorescence camera system. Their mean age was 71.4\u00b16.4 (58\u201378) years; 80 were men, and 2 were women. The mean operative time was 534.6 \u00b1 94.5 min. The coloanal anastomosis was performed in 80%, and 20% underwent abdominal peritoneal resection. Two patients encountered postoperative complications graded as Clavien\u2013Dindo grade 2. The transanal approach with IRIS U kit assistance is feasible, safe for patients with lower rectal cancer, and may prevent intraoperative urethral injury.<\/jats:p>","DOI":"10.1186\/s12876-024-03279-8","type":"journal-article","created":{"date-parts":[[2024,6,17]],"date-time":"2024-06-17T05:01:45Z","timestamp":1718600505000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["IRIS U kit usefulness in transanal total mesorectal excision for lower rectal cancer to avoid urethral injury"],"prefix":"10.1186","volume":"24","author":[{"given":"Masatsugu","family":"Ishii","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Toshikatsu","family":"Nitta","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jun","family":"Kataoka","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yasuhiko","family":"Ueda","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ayumi","family":"Matsutani","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masataka","family":"Taki","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ryutaro","family":"Kubo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masato","family":"Ota","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takashi","family":"Ishibashi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2024,6,17]]},"reference":[{"key":"3279_CR1","doi-asserted-by":"publisher","first-page":"3165","DOI":"10.1007\/s00464-013-2872-0","volume":"27","author":"AM deLacy","year":"2013","unstructured":"deLacy AM, Rattner DW, Adelsdorfer C, Tasende MM, Fernandes M, Delgado S, Sylla P, Martines-Palli G. Transanal natural orifice transluminal endoscopic surgery (NOTES) rectal resection: \u201cDown-to-up\u201d total mesorectal excision (TME)\u2013-short-term outcomes in the first 20 cases. Surg Endosc. 2013;27:3165\u201372.","journal-title":"Surg Endosc"},{"key":"3279_CR2","doi-asserted-by":"publisher","first-page":"69","DOI":"10.1007\/s10151-014-1233-x","volume":"19","author":"SE Araujo","year":"2014","unstructured":"Araujo SE, Crawshaw B, Mendes CR, Delaney CP. Transanal total mesorectal excision: a systematic review of the experimental and clinical evidence. Tech Coloproctol. 2014;19:69\u201382.","journal-title":"Tech Coloproctol"},{"key":"3279_CR3","doi-asserted-by":"publisher","first-page":"967","DOI":"10.1007\/s00276-017-1832-0","volume":"39","author":"Y Nakajima","year":"2017","unstructured":"Nakajima Y, Muro S, Nasu H, Harada M, Yamaguchi K, Akita K. Morphology of the region anterior to the ana canal in males: visualization of the anterior bundle of the longitudinal muscle by transanal ultrasonography. Surg Radiol Anat. 2017;39:967\u201373.","journal-title":"Surg Radiol Anat"},{"key":"3279_CR4","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1016\/j.amsu.2019.08.002","volume":"46","author":"Toshikatsu Nitta","year":"2019","unstructured":"Nitta Toshikatsu, Tanaka Keitaro, Kataoka Jun, Ohta Masato, Ishii Masatsugu, Ishibashi Takashi, Okuda Junji. Novel technique with the IRIS U kit to prevent urethral injury in patients undergoing transanal total mesorectal excision. Ann Med Sur (Lond). 2019;46:1\u20133.","journal-title":"Ann Med Sur (Lond)"},{"key":"3279_CR5","doi-asserted-by":"publisher","first-page":"57","DOI":"10.1007\/s10151-014-1254-5","volume":"19","author":"S Atallah","year":"2015","unstructured":"Atallah S. Transanal total mesorectal excision: full steam ahead. Tech Coloproctol. 2015;19:57\u201361.","journal-title":"Tech Coloproctol"},{"key":"3279_CR6","doi-asserted-by":"publisher","first-page":"2552","DOI":"10.1007\/s00464-015-4521-2","volume":"30","author":"L Kang","year":"2016","unstructured":"Kang L, Chen WH, Luo SL, Luo YX, Liu ZH, Huang MJ, Wang JP. Transanal total mesorectal excision for rectal cancer\u202f: a preliminary report. Surg Endosc. 2016;30:2552\u201362.","journal-title":"Surg Endosc"},{"key":"3279_CR7","doi-asserted-by":"publisher","first-page":"408","DOI":"10.1097\/DCR.0b013e3182756fa0","volume":"56","author":"P Rouanet","year":"2013","unstructured":"Rouanet P, Mourregot A, Azar CC, Carrere S, Gutowski M, Quenet F, Saint-Aubert B, Colombo PE. Transanal endoscopic proctectomy: an innovative procedure for difficultresection of rectal tumors in men with narrow pelvis. Dis Colon Rectum. 2013;56:408\u201315.","journal-title":"Dis Colon Rectum"},{"key":"3279_CR8","doi-asserted-by":"publisher","first-page":"679","DOI":"10.1007\/s10151-015-1329-y","volume":"19","author":"S Attallah","year":"2015","unstructured":"Attallah S, Martin-Perez B, Larach S. Image-guided real-time navigaton for transanal total mesorectal excision: a pilot study. Tech Coloproctol. 2015;19:679\u201384.","journal-title":"Tech Coloproctol"},{"key":"3279_CR9","doi-asserted-by":"publisher","first-page":"1205","DOI":"10.1007\/s00464-010-0965-6","volume":"24","author":"P Sylla","year":"2010","unstructured":"Sylla P, Rattner DW, Delgado S, Lacy AM. NOTES transanal rectal cancer resection using transanal endoscopic microsurgery and laparoscopic assistance. Surg Endosc. 2010;24:1205\u201310.","journal-title":"Surg Endosc"},{"key":"3279_CR10","doi-asserted-by":"publisher","first-page":"2080","DOI":"10.1007\/s00464-011-2117-z","volume":"26","author":"AM Lacy","year":"2012","unstructured":"Lacy AM, Saavedra-Perez D, Bravo R, Adelsdorfer C, Aceituno M, Balust J. Minilaparoscopy-assisted natural orifice total colectomy: technical report of a minilaparoscopy-assisted transrectal resection. Surg Endosc. 2012;26:2080\u20135.","journal-title":"Surg Endosc"},{"key":"3279_CR11","doi-asserted-by":"publisher","first-page":"339","DOI":"10.1007\/s00464-012-2443-9","volume":"27","author":"AM Lacy","year":"2013","unstructured":"Lacy AM, Adelsdorfer C, Delgado S, Sylla P, Rattner DW. Minilaparoscopy-assisted transrectal low anterior resection (LAR): a preliminary study. Surg Endosc. 2013;27:339\u201346.","journal-title":"Surg Endosc"},{"key":"3279_CR12","doi-asserted-by":"publisher","first-page":"325","DOI":"10.1016\/j.giec.2008.01.006","volume":"18","author":"JP Pearl","year":"2008","unstructured":"Pearl JP, Marks JM, Ponsky JL. Hybrid surgery: combined laparoscopy and natural orifice surgery. Gastrointest Endosc Clin N Am. 2008;18:325\u201332.","journal-title":"Gastrointest Endosc Clin N Am"},{"key":"3279_CR13","doi-asserted-by":"publisher","first-page":"1512","DOI":"10.1007\/s00464-009-0428-0","volume":"23","author":"S Horgan","year":"2009","unstructured":"Horgan S, Cullen JP, Talamini MA, Mintz Y, Ferreres A, Jacobsen GR, Sandler B, Bosia J, Savides T, Easter DW, Savu MK, Ramamoorthy SL, Whitcomb E, Agarwal S, Lukacz E, Dominguez G, Ferraina P. Natural orifice surgery: initial clinical experience. Surg Endosc. 2009;23:1512\u20138.","journal-title":"Surg Endosc"},{"key":"3279_CR14","doi-asserted-by":"publisher","first-page":"1718","DOI":"10.1016\/S0140-6736(05)66545-2","volume":"365","author":"Guillou PJ, Quirke P, Thorpe H, Walker J, Jayne DG, Smith AM, Heath RM, Brown JM; MRC CLASICC Trial Group","year":"2005","unstructured":"Guillou PJ, Quirke P, Thorpe H, Walker J, Jayne DG, Smith AM, Heath RM, Brown JM; MRC CLASICC Trial Group. Short-term endpoints of conventional versus laparoscopic assisted surgery in patients with colorectal cancer (MRC CLASICC trial): multicentre randomised controlled trial. Lancet. 2005;365:1718\u201326.","journal-title":"Lancet"},{"issue":"6","key":"3279_CR15","doi-asserted-by":"publisher","first-page":"674","DOI":"10.1016\/j.asjsur.2018.09.008","volume":"42","author":"YT Chen","year":"2019","unstructured":"Chen YT, Kiu KT, Yen MH, Chang TC. Comparison of the short-term outcomes in lower rectal cancer using three different surgical techniques: transanal Total Mesorectal Excision (TME), laparoscopic TME, and open TME. Asian J Surg. 2019;42(6):674\u201380.","journal-title":"Asian J Surg."},{"issue":"11","key":"3279_CR16","doi-asserted-by":"publisher","first-page":"2197","DOI":"10.1016\/j.asjsur.2021.11.009","volume":"45","author":"HB Jang","year":"2022","unstructured":"Jang HB, Kang SB, Lee H, Choi BJ, Lee SC. Anastomotic leakage and chroic presacral sinus after transanal total mesorectal excision (taTME) for rectal cancer: a comparative study to laparoscopic TME. Asian J Surg. 2022;45(11):2197\u20132022.","journal-title":"Asian J Surg."},{"issue":"1","key":"3279_CR17","doi-asserted-by":"publisher","first-page":"330","DOI":"10.1016\/j.asjsur.2019.06.010","volume":"43","author":"JM Hu","year":"2020","unstructured":"Hu JM, Chu CH, Jiang JK, Lai YL, Huang IP, Cheng AY, Yang SH, Chen CC. Robotic transanal total mesorectal excision assisted by laparoscopic transabdominal approach: a preliminary twenty-case series report. Asian J Surg. 2020;43(1):330\u20138.","journal-title":"Asian J Surg."},{"key":"3279_CR18","doi-asserted-by":"publisher","first-page":"439","DOI":"10.1007\/s10151-017-1615-y","volume":"21","author":"TG Barnes","year":"2017","unstructured":"Barnes TG, Penna M, Hompes R, Cunningham C. Fluorescence to highlight the urethra: a human cadaveric study. Tech Coloproctol. 2017;21:439\u201344.","journal-title":"Tech Coloproctol"}],"container-title":["BMC Gastroenterology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12876-024-03279-8.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12876-024-03279-8\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12876-024-03279-8.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,6,17]],"date-time":"2024-06-17T05:05:11Z","timestamp":1718600711000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmcgastroenterol.biomedcentral.com\/articles\/10.1186\/s12876-024-03279-8"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,6,17]]},"references-count":18,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2024,12]]}},"alternative-id":["3279"],"URL":"https:\/\/doi.org\/10.1186\/s12876-024-03279-8","relation":{"has-preprint":[{"id-type":"doi","id":"10.21203\/rs.3.rs-3194674\/v1","asserted-by":"object"}]},"ISSN":["1471-230X"],"issn-type":[{"value":"1471-230X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,6,17]]},"assertion":[{"value":"20 January 2024","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"31 May 2024","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"17 June 2024","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"This study was approved by the institutional review board of the Shiroyama Hospital (committee Number is 2018-004). Written informed consent was obtained from all patients.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable. Individual identifying data were not included in this manuscript.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"203"}}