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Laparoscopic surgery is a technically demanding procedure that requires a significant level of experience and expertise. Since surgery is the mainstay treatment of rectal cancer, comprehending the complexities of multilaminar structures and interfascial spaces is imperative.
This is the case of a 68-year-old woman who was evaluated for a positive fecal occult blood test. Colonoscopy found a vegetative lesion 15 cm from the anal verge, occupying ~1/2 of the lumen. Biopsy and distal tattooing were performed. Pathology study confirmed the presence of a moderately differentiated adenocarcinoma.
The CT-scan showed no lung or liver metastasis. MRI revealed an upper rectal cancer, 11.4 cm from the anal verge, with no pathological lymph nodes, staged as cT2 N0 Mx CRM-.
After discussion in a multidisciplinary meeting, a laparoscopic anterior rectal resection was proposed.
By segmentation of the surgery into well-organized stages, this video demonstrates all the important technical steps to fasten the learning curve and master the procedure without compromising the oncologic principles.
No disclosure of conflicts.
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2. Heald RJ. A new approach to rectal cancer. Br J Hosp Med 1979;22:277-81.
3. Dahlberg M, Påhlman L, Bergström R, et al. Improved survival in patients with rectal cancer: a population-based register study. Br J Surg 1998;85:515-20.
4. Vennix S, Pelzers L, Bouvy N, et al. Laparoscopic versus open total mesorectal excision for rectal cancer. Cochrane Database Syst Rev 2014;CD005200
5. Lin A Y. Philadelphia PA: Elsevier Saunders; 2013. Open low anterior resection of rectum.
6. Nagtegaal I D, Quirke P. What is the role for the circumferential margin in the modern treatment of rectal cancer? J Clin Oncol. 2008;26(2):303–312.
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This is approved for 0.5 AMA PRA Category 1 Credit™ via CineMed (ACCME / ACPE / ANCC). The two viewing modes are different — pick what fits your time.
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