Surgery Today

, Volume 35, Issue 7, pp 598–602 | Cite as

Laparoscopy-Assisted Low Anterior Resection with a Prolapsing Technique for Low Rectal Cancer

  • Masaki Fukunaga
  • Akio Kidokoro
  • Toshiaki Iba
  • Kazuyoshi Sugiyama
  • Tetu Fukunaga
  • Kunihiko Nagakari
  • Masaru Suda
  • Seiichiro Yoshikawa
How to Do It

Abstract

Laparoscopy-assisted low anterior resection (LAR) for low rectal cancer is a difficult procedure, presenting problems with rectal washout, selecting the appropriate distal transection line, and achieving safe anastomosis. To resolve these problems, we used a prolapsing technique to perform laparoscopy-assisted LAR. Total mesorectal excision (TME) is performed laparoscopically. The proximal colon is transected laparoscopically with the aid of an endoscopic stapler, and the distal rectum, including the lesion, are everted and pulled transanally to outside the body. Only washout of and wiping off the distal rectum and intestinal resection are performed extracorporeally. The distal rectum is pushed back through the anus into the pelvis, and intracorporeal anastomosis is completed laparoscopically with a double-stapling technique. Our limited experience suggests that the prolapsing technique helps to prevent problems with laparoscopy-assisted LAR in selected patients with low rectal cancer.

Key words

Rectal cancer Laparoscopy-assisted low anterior resection Prolapsing technique 

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Copyright information

© Springer-Verlag Tokyo 2005

Authors and Affiliations

  • Masaki Fukunaga
    • 1
  • Akio Kidokoro
    • 1
  • Toshiaki Iba
    • 1
  • Kazuyoshi Sugiyama
    • 1
  • Tetu Fukunaga
    • 1
  • Kunihiko Nagakari
    • 1
  • Masaru Suda
    • 1
  • Seiichiro Yoshikawa
    • 1
  1. 1.Department of Surgery, Juntendo Urayasu HospitalJuntendo UniversityUrayasuJapan

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