Skip to main content

Laparoscopic Low Anterior Resection for Rectal Cancer: TME Planes and Surgery of theĀ Upper and Mid-Rectum

  • Chapter
  • First Online:
The SAGES Manual of Colorectal Surgery
  • 1315 Accesses

Abstract

Despite years of literature demonstrating the safety, feasibility, and benefit of a minimally invasive surgical approach to colon cancer, half of the colectomies in the USA are still performed via an open approach. In this chapter, we will outline the workup, surgical setup, and operative steps for laparoscopic low anterior resection with special considerations for mid- and upper rectal cancers. We also provide tips for exposing the proper planes and how to avoid common intraoperative missteps. Our goal is to equip the novice minimally invasive surgeon with the tools needed to safely perform laparoscopic colorectal resections.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

eBook
USD 16.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 119.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Taylor F, Quirke P, Heald R, Moran B, Blomqvist L, Swift I, et al. Preoperative high-resolution magnetic resonance imaging can identify good prognosis stage I, II, and III rectal cancer best managed by surgery alone. Ann Surg. 2011;253(4):711ā€“9.

    ArticleĀ  Google ScholarĀ 

  2. Fleshman J, Branda M, Sargent DJ, Boller AM, George V, Abbas M, et al. Effect of laparoscopic-assisted resection vs open resection of stage II or III rectal cancer on pathologic outcomes: the ACOSOG Z6051 randomized clinical trial. JAMA. 2015;314(13):1346ā€“55.

    ArticleĀ  CASĀ  Google ScholarĀ 

  3. Stevenson ARL, Solomon MJ, Lumley JW, Hewett P, Clouston AD, Gebski VJ, et al. Effect of laparoscopic-assisted resection of open resection on pathological outcomes in rectal cancer: the ALACART trial. JAMA. 2015;314(13):1356ā€“63.

    ArticleĀ  CASĀ  Google ScholarĀ 

  4. https://www.Facs.org/Quality-Programs/Cancer/Naprc/Standards.

  5. Matsuda K, Yokoyama S, Hotta T, Hakifuji K, Watanabe T, Tamura K, et al. Oncological outcomes following rectal cancer surgery with high or low ligation of the inferior mesenteric artery. Gastrointest Tumors. 2017;4(1ā€“2):45ā€“52.

    ArticleĀ  Google ScholarĀ 

  6. Matsuda K, Hotta T, Takifuji K, Yokoyama S, Oku Y, Watanabe T, et al. Randomized clinical trial of defaecatory function after anterior resection for rectal cancer with high versus low ligation of the inferior mesenteric artery. Br J Surg. 2015;102(5):501ā€“8.

    ArticleĀ  CASĀ  Google ScholarĀ 

  7. Fujii S, Ishibe A, Ota M, Watanabe K, Watanabe J, Kunisaki C, et al. Randomized clinical trial of high versus low inferior mesenteric artery ligation during anterior resection for rectal cancer. BJS Open. 2018;2(4):195ā€“202.

    ArticleĀ  CASĀ  Google ScholarĀ 

  8. Mari GM, Crippa J, Cocozza E, Berselli M, Livraghi L, Carzaniga P, et al. Low ligation of inferior mesenteric artery in laparoscopic anterior resection for rectal cancer reduces genitourinary dysfunction. Ann Surg. 2018; https://doi.org/10.1097/SLA.0000000000002947. [Epub ahead of print]

  9. Jeong SY, Park JW, Nam BH, Kim S, Kang SB, Lim SB, et al. Open versus laparoscopic surgery for mid-rectal or low-rectal cancer after neoadjuvant chemoradiotherapy (COREAN trial): short-term outcomes of an open-label randomised controlled trial. Lancet Oncol. 2010;11(7):637ā€“45.

    ArticleĀ  Google ScholarĀ 

  10. Fleshman J, Branda ME, Sargent DJ, Boller AM, George VV, Abbas MA, et al. Disease-free survival and local recurrence for laparoscopic resection compared with open reseciton fo stage II to III rectal cancer: follow-up results of the ACOSOG Z6051 randomized controlled trial. Ann Surg. 2019;269(4):589ā€“95.

    ArticleĀ  Google ScholarĀ 

  11. Jeong SY, Park JW, Nam BH, Kim S, Kang SB, Lim SB, et al. Open versus laparoscopic surgery for mid-rectal or low-rectal cancer after neoadjuvant chemoradiotherapy (COREAN trial): survival outcomes of an open-label, noninferiority, randomized controlled trial. Lancet Oncol. 2014;15(7):767ā€“74.

    ArticleĀ  Google ScholarĀ 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Eric M. Haas .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

Ā© 2020 Society of American Gastrointestinal and Endoscopic Surgeons (SAGES)

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Haas, E.M., Hayman, A.V. (2020). Laparoscopic Low Anterior Resection for Rectal Cancer: TME Planes and Surgery of theĀ Upper and Mid-Rectum. In: Sylla, P., Kaiser, A., Popowich, D. (eds) The SAGES Manual of Colorectal Surgery. Springer, Cham. https://doi.org/10.1007/978-3-030-24812-3_23

Download citation

  • DOI: https://doi.org/10.1007/978-3-030-24812-3_23

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-24811-6

  • Online ISBN: 978-3-030-24812-3

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics