Use of a linear stapler for urethral and dorsal vein complex transection during laparoscopic total pelvic exenteration in rectal cancer

  • A. Kondo
  • Y. NishizawaEmail author
  • H. Tsunemori
  • H. Taketani
  • N. Yamamoto
  • H. Okazoe
  • T. Fujita
  • M. Sugimoto
  • Y. Suzuki
Trick of the Trade


Dorsal vein complex (DVC) and urethral transection during total pelvic exenteration (TPE) is time-consuming, technically challenging, and associated with a high rate of hemorrhage. Although laparoscopic surgery is associated with less intraoperative blood loss during TPE [1], it is still technically challenging to perform in DVC and urethral transection. Techniques for transecting the DVC during radical prostatectomy have been reported [2, 3, 4]. Concerning the surgical technique of TPE for rectal malignancy, only limited studies have described the technique used for DVC and urethral transection. Hayashi et al. reported that the urethra could be successfully transected using a linear stapler, but the DVC was not successfully transected [5]. Techniques using a linear stapler for transection of the DVC and urethra have not been described.

We describe our simple technique for transecting the DVC and urethra easily and without significant bleeding during laparoscopic TPE in...


Author contributions

All authors contributed to this study and approved the final submitted version. AK and YN collected the data and wrote the manuscript.


This study was only funded by Takamatsu Hospital, Federation of National Public Service Personnel Mutual Aid Associations, Kagawa, Japan.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. The study was approved by the institutional review board.

Informed consent

Informed consent was obtained from the patient for publication and presentation of this article and accompanying images.


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Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.Department of Surgery, Takamatsu HospitalFederation of National Public Service Personnel Mutual Aid AssociationsTakamatsuJapan
  2. 2.Department of Gastrointestinal Surgery, Faculty of MedicineKagawa UniversityKagawaJapan
  3. 3.Department of Colorectal SurgeryNational Cancer Center Hospital EastKashiwaJapan
  4. 4.Department of UrologyKagawa University Graduate School of MedicineKagawaJapan
  5. 5.Department of Urology, Takamatsu HospitalFederation of National Public Service Personnel Mutual Aid AssociationsTakamatsuJapan

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