Laparoscopic Small Intestinal Tumor Resection with Transvaginal Specimen Extraction

The incidence of small bowel tumors is low and accounts for 5% of digestive tract tumors and 2% of malignant digestive tract tumors. Small bowel tumors are most common in middle-aged people aged 30–59 years with a male to female ratio of 1.5–2.4:1. According to the literatures at home and abroad, most small bowel tumors are malignant. Adenocarcinomas, neuroendocrine tumors, stromal tumors, and lymphomas are the main malignant tumors. The clinical manifestations of small bowel tumors are nonspecific. At present, surgical resection is the main treatment method for small bowel tumors. The surgical methods include laparotomy, endoscopic surgery, laparoscopic surgery, combined endoscopic and laparoscopic surgery, etc. Laparoscopic small bowel tumor resection has been widely used in the clinical practice, but auxiliary incision has to be made for specimen extraction and digestive tract reconstruction. Laparoscopic small bowel tumor resection with specimen extraction through the natural orifice has been rarely reported. With the gradual popularization of the minimally invasive concept of NOSES and the improvement of surgeons’ operating skills in NOSES, the technique of NOSES can be applied for the treatment of small bowel tumors. Specimen extraction through the natural orifice can avoid auxiliary incision in the abdominal wall and only leave a few tiny trocar scars on the abdominal wall after the surgery. NOSES exhibits perfect minimally invasive effect. As a technique that’s easy to operate, replicate, and promote, NOSES exhibits great vitality. In this chapter, the laparoscopic resection of small bowel tumors with transvaginal specimen extraction is introduced.