Push-Back Technique Facilitates Ultra-Low Anterior Resection without Nerve Injury in Total Mesorectal Excision for Rectal Cancer

2011 ◽  
Vol 28 (4) ◽  
pp. 239-244 ◽  
Author(s):  
Yasuhiro Inoue ◽  
Junichiro Hiro ◽  
Yuji Toiyama ◽  
Koji Tanaka ◽  
Keiichi Uchida ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Total Mesorectal Excision ◽  
Nerve Injury ◽  
Anterior Resection ◽  
Low Anterior Resection ◽  
Mesorectal Excision

scholarly journals Single-incision Plus One Port Laparoscopic Total Mesorectal Excision and Bilateral Pelvic Node Dissection for Advanced Rectal Cancer—A Medial Umbilical Ligament Approach

2015 ◽  
Vol 100 (3) ◽  
pp. 417-422 ◽  
Author(s):  
Masayoshi Tokuoka ◽  
Yoshihito Ide ◽  
Mitsunobu Takeda ◽  
Yasuji Hashimoto ◽  
Jin Matsuyama ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Lymph Nodes ◽  
Total Mesorectal Excision ◽  
Anterior Resection ◽  
Low Anterior Resection ◽  
Single Incision ◽  
Advanced Rectal Cancer ◽  
Laparoscopic Total Mesorectal Excision ◽  
Node Dissection ◽  
Mesorectal Excision

We prove the safety and feasibility of single-incision plus 1 port (SILS+1) laparoscopic total mesorectal excision (TME) + lateral pelvic lymph node dissection (LPLD) via a medial umbilical approach for rectal cancer. Only a few reports have been published about single-incision multiport laparoscopic low anterior resection with LPLD. Recently, minimally invasive surgery such as single-incision plus 1 port (SILS + 1) for advanced rectal cancer has been reported as safe and feasible. To our knowledge, this is the first reported case of SILS + 1 used for LPLD. A wound protector was inserted through a 30-mm transumbilical incision. Next, a single-port access device was mounted to the wound protector and 3 ports (5 mm each) were placed. A 12-mm port was inserted in the right lower quadrant. Super-low anterior resection of the rectum and bilateral LPLD and temporary ileostomy were performed with SILS + 1, with a blood loss of 50 mL and a total surgical time of 525 minutes. The time for right lateral dissection was 74 minutes; the time for left lateral dissection was 118 minutes. The total number of dissected lymph nodes was 57 and the number of lateral lymph nodes dissected was 21 (8 left pelvic lymph nodes, 13 right pelvic lymph nodes). No postoperative anastomotic insufficiency or voiding dysfunction was observed. We have documented the safety and feasibility of SILS + 1-TME + LPLD via a medial umbilical approach for rectal cancer.

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