Masters of Gastrointestinal Surgery

Laparoscopic radical resection for rectal cancer

Xuefei Yang, Chang Zhu, Mingli Yang, Haijun Hu, Ligang Xia, Kai Pan


Compared with conventional open surgery for rectal cancer, laparoscopic radical resection requires a more profound understanding of the local anatomy. A successful approach relies on adequate resection scope and lymph node dissection. In laparoscopic radical resection for rectal cancer, the inferior mesenteric blood vessels are required to be ligated at the origin for dissection of the third station lymph nodes; the laparoscopic surgical plane is set so close to the lateral peritoneum that the lymph nodes in the sigmoid mesocolon, or the second station lymph nodes, can be dissected; and a complete, sharp separation is made along the pelvic fascia anterior to the sacrum along to ensure complete resection of the rectal tumor and mesorectum (first station juxtaintestinal lymph nodes).