Advertisement

Minimally Invasive Low Anterior Resection

  • Matthew AlbertEmail author
  • Marc Dakermandji
Chapter

Abstract

Laparoscopic low anterior resection (LAR) for rectal cancer remains one of the most challenging colorectal operations. Its aim is proper oncologic resection with total mesorectal excision (TME) while striving to minimize the morbidity associated with a low pelvic anastomosis. Additionally, it combines the necessary challenge of splenic flexure mobilization prior to deep pelvic dissection to achieve a well-perfused, tension-free colorectal anastomosis. Thus, a systematic approach to managing the colonic mesentery of the left upper quadrant and the embryologic planes of the pelvis for TME is critical for a proper anatomic dissection and successful outcome. In this chapter, we describe our approach to LAR with a minimally invasive approach.

Keywords

Low anterior resection Laparoscopic Video Technical note 

Supplementary material

Video 22.1

Video demonstrating a laparoscopic Laparoscopic low anterior resection (LAR) medial-to-lateral dissection pneumoperitoneum splenic flexure mobilization and low anterior resection (MP4 137736 kb)

References

  1. 1.
    Monson JR, Weiser MR, Buie WD, Chang GJ, Rafferty JF, Buie WD, Rafferty J. Standards Practice Task Force of the American Society of Colon and Rectal Surgeons Practice Parameters for the Management of Rectal Cancer (Revised). Dis Colon Rectum. 2013;56:535–50.Google Scholar
  2. 2.
    Ludwig, Kirk, Kosinski, Lauren. Is Splenic Flexure Mobilization Necessary in Laparoscopic Anterior Resection? Another View Diseases of the Colon & Rectum, 2012, Vol. 5, 1198–1200.Google Scholar
  3. 3.
    Foppa C, Denoya P, Tarta C, et al. Indocyanine green fluorescent dye during bowel surgery: are the blood supply “guessing days” over? Tech Coloproctol. 2014;18:753–8.CrossRefGoogle Scholar
  4. 4.
    Wada T, Kawada K, Takahashi R, et al. ICG fluorescence imaging for quantitative evaluation of colonic perfusion in laparoscopic colorectal surgery. Surg Endosc. 2017;31:4184.CrossRefGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2020

Authors and Affiliations

  1. 1.Department of Colorectal SurgeryCenter for Colon & Rectal Surgery, Florida HospitalOrlandoUSA

Personalised recommendations