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Laparoscopic Low Anterior Resection with Total Mesorectal Excision for Rectal Cancer

Hao Feng*1,3, Zhi-hai Mao*1, Wen-qing Feng1, Jing-kun Zhao1, Cong-cong Zhu1, Xiao-Hui Shen2, Wolfgang E. Thasler3, Ai-guo Lu1, Min-hua Zheng1
* These authors contributed equally

Abstract

Over the last few decades, laparoscopic total mesorectum excision has become a common procedure used in the treatment of stage I-III rectal cancers. When the tumor is located in the upper part of the rectum, low anterior resection (LAR) can be performed to remove the part of the rectum containing the tumor. In addition, faster recovery, less blood loss, and lower complications rates have been achieved by laparoscopic approach. In this protocol, the laparoscopic low anterior resection is performed through five cannulas. The rectum is mobilized with laparoscopic devices such as laparoscopic shears. The visceral and parietal pelvic fascia are dissected without injuring the hypogastric nerves and pelvic neurovascular bundles. The part of the rectum containing the tumor is removed and the colon is then attached to the remaining part of the rectum.

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