[Anterior resection of the rectum via laparoscopy]. 1998

C Vasilescu, and V Tomulescu, and I Călin, and E Nuraltay
Clinica Chirurgie Generală Fundeni.

Of the newer laparoscopic procedures for colorectal cancers the abdominoperineal resection of the rectum was previously communicated in this journal. The laparoscopic anterior resection is a more technically demanding operation. We report the case of 63 years old women with a rectal cancer at 9 cm from the anus. The procedure was realised under general anaesthesia, with a urinary catheter in place. An blunt obturator was introduced into the uterine cavity and used to manipulate the uterus during the procedure. After establishing of the pneumoperitoneum, a 30 degrees telescope was introduced through the umbilical port (10 mm). The 30 degrees telescope allows visualization of the splenic flexure and rectal side wall. The main steps of the procedure were the exploration of the abdominal cavity, mobilization of the descendent colon and sigmoid, exposure of the left ureter, division of the left sided peritoneal leaf and division of the inferior mesenteric vessels. The anterior dissection of the rectum was facilitated by manipulation of the uterus. The rectum was then mobilized with the "abdominalization of the tumor". A 5 cm left paramedian vertical incision was performed; through this incision a stapler was introduced and the rectum was transected 5 cm under the tumor. The rectum with the tumor, the sigmoid and mesosigmoid were exteriorized through the incision; the sigmoid was divided with a linear stapler cutter 20 cm above the tumor and the specimen was removed extracorporeally. The anvil of a circular stapler was secured in the left colon and returned in the abdominal cavity. The body of the stapler was inserted into the rectal stump through the anus and connected intracorporeally to the anvil. The postoperative evolution was simple; flatus and feces were passed at 48 hours. The patient was discharged to home after 6 days, 13 months after operation she has no morbidity.

UI MeSH Term Description Entries
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D010535 Laparoscopy A procedure in which a laparoscope (LAPAROSCOPES) is inserted through a small incision near the navel to examine the abdominal and pelvic organs in the PERITONEAL CAVITY. If appropriate, biopsy or surgery can be performed during laparoscopy. Celioscopy,Laparoscopic Surgical Procedures,Peritoneoscopy,Surgical Procedures, Laparoscopic,Laparoscopic Assisted Surgery,Laparoscopic Surgery,Laparoscopic Surgical Procedure,Procedure, Laparoscopic Surgical,Procedures, Laparoscopic Surgical,Surgery, Laparoscopic,Surgical Procedure, Laparoscopic,Celioscopies,Laparoscopic Assisted Surgeries,Laparoscopic Surgeries,Laparoscopies,Peritoneoscopies,Surgeries, Laparoscopic,Surgeries, Laparoscopic Assisted,Surgery, Laparoscopic Assisted
D012004 Rectal Neoplasms Tumors or cancer of the RECTUM. Cancer of Rectum,Rectal Cancer,Rectal Tumors,Cancer of the Rectum,Neoplasms, Rectal,Rectum Cancer,Rectum Neoplasms,Cancer, Rectal,Cancer, Rectum,Neoplasm, Rectal,Neoplasm, Rectum,Rectal Cancers,Rectal Neoplasm,Rectal Tumor,Rectum Cancers,Rectum Neoplasm,Tumor, Rectal
D012007 Rectum The distal segment of the LARGE INTESTINE, between the SIGMOID COLON and the ANAL CANAL. Rectums
D003131 Combined Modality Therapy The treatment of a disease or condition by several different means simultaneously or sequentially. Chemoimmunotherapy, RADIOIMMUNOTHERAPY, chemoradiotherapy, cryochemotherapy, and SALVAGE THERAPY are seen most frequently, but their combinations with each other and surgery are also used. Multimodal Treatment,Therapy, Combined Modality,Combined Modality Therapies,Modality Therapies, Combined,Modality Therapy, Combined,Multimodal Treatments,Therapies, Combined Modality,Treatment, Multimodal,Treatments, Multimodal
D005260 Female Females
D006488 Hemostasis, Surgical Control of bleeding during or after surgery. Surgical Hemostasis,Hemostases, Surgical,Surgical Hemostases
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000230 Adenocarcinoma A malignant epithelial tumor with a glandular organization. Adenocarcinoma, Basal Cell,Adenocarcinoma, Granular Cell,Adenocarcinoma, Oxyphilic,Adenocarcinoma, Tubular,Adenoma, Malignant,Carcinoma, Cribriform,Carcinoma, Granular Cell,Carcinoma, Tubular,Adenocarcinomas,Adenocarcinomas, Basal Cell,Adenocarcinomas, Granular Cell,Adenocarcinomas, Oxyphilic,Adenocarcinomas, Tubular,Adenomas, Malignant,Basal Cell Adenocarcinoma,Basal Cell Adenocarcinomas,Carcinomas, Cribriform,Carcinomas, Granular Cell,Carcinomas, Tubular,Cribriform Carcinoma,Cribriform Carcinomas,Granular Cell Adenocarcinoma,Granular Cell Adenocarcinomas,Granular Cell Carcinoma,Granular Cell Carcinomas,Malignant Adenoma,Malignant Adenomas,Oxyphilic Adenocarcinoma,Oxyphilic Adenocarcinomas,Tubular Adenocarcinoma,Tubular Adenocarcinomas,Tubular Carcinoma,Tubular Carcinomas
D020706 Laparoscopes ENDOSCOPES for examining the abdominal and pelvic organs in the peritoneal cavity. Celioscopes,Peritoneoscopes,Laparoscope,Celioscope,Peritoneoscope

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