Laparoscopy-assisted low anterior resection with a prolapsing technique for low rectal cancer.

Abstract:

:Laparoscopy-assisted low anterior resection (LAR) for low rectal cancer is a difficult procedure, presenting problems with rectal washout, selecting the appropriate distal transection line, and achieving safe anastomosis. To resolve these problems, we used a prolapsing technique to perform laparoscopy-assisted LAR. Total mesorectal excision (TME) is performed laparoscopically. The proximal colon is transected laparoscopically with the aid of an endoscopic stapler, and the distal rectum, including the lesion, are everted and pulled transanally to outside the body. Only washout of and wiping off the distal rectum and intestinal resection are performed extracorporeally. The distal rectum is pushed back through the anus into the pelvis, and intracorporeal anastomosis is completed laparoscopically with a double-stapling technique. Our limited experience suggests that the prolapsing technique helps to prevent problems with laparoscopy-assisted LAR in selected patients with low rectal cancer.

journal_name

Surg Today

journal_title

Surgery today

authors

Fukunaga M,Kidokoro A,Iba T,Sugiyama K,Fukunaga T,Nagakari K,Suda M,Yoshikawa S

doi

10.1007/s00595-004-2984-1

subject

Has Abstract

pub_date

2005-01-01 00:00:00

pages

598-602

issue

7

eissn

0941-1291

issn

1436-2813

journal_volume

35

pub_type

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