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The level of ligation of the inferior mesenteric artery during rectosigmoid resection has been discussed in the literature over the past few years. A high ligation (at the origin from the aorta) has the benefit of a high lymph-node yield, while a low ligation (preserving the left colic artery) can increase blood flow to a colorectal anastomosis, but may leave involved lymph nodes in situ. A compromise between these techniques has been described, wherein a low ligation is paired with a dissection of the apical inferior mesenteric artery and para-aortic lymph nodes. We demonstrate and explain this technique in our video presentation.
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Guidolin, K., Chadi, S.A. & Quereshy, F.A. Low ligation of the inferior mesenteric artery with apical lymph-node dissection during rectosigmoid resection for preservation of the left colic artery. Tech Coloproctol 25, 139 (2021). https://doi.org/10.1007/s10151-020-02306-6
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DOI: https://doi.org/10.1007/s10151-020-02306-6