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Proctectomy and Rectopexy: Laparoscopic Approach

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Advanced Techniques in Minimally Invasive and Robotic Colorectal Surgery

Abstract

Procedures in the lower rectum can be particularly challenging for any surgeon. The bony pelvis constricts the amount of space available, particularly in males. Finding the right plane can be a difficult experience but is of paramount importance as it has oncologic, functional, and anatomic implications. This chapter seeks to explore three rectal procedures in depth: low anterior resection (LAR), abdominoperineal resection (APR), and rectopexy. Our goal is to describe techniques, pitfalls, and pearls that help the pelvic surgeon complete these procedures safely and efficiently.

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References

  1. Lim CS, Mehigan JB, Hartley JE, Monson JR. Neoadjuvant therapy in the treatment of high risk rectal carcinoma. Surg Oncol. 1999;8(1):1–11.

    Article  PubMed  Google Scholar 

  2. Williams NS, Dixon MF, Johnston D. Reappraisal of the 5 centimetre rule of distal excision for carcinoma of the rectum: a study of distal intramural spread and of patients’ survival. Br J Surg. 1983;70(3):150–4.

    Article  CAS  PubMed  Google Scholar 

  3. Breukink S, et al. Laparoscopic versus open total mesorectal excision for rectal cancer. Cochrane Database Syst Rev. 2006;18(4):CD005200.

    Google Scholar 

  4. Leroy J, et al. Laparoscopic total mesorectal excision (TME) for rectal cancer surgery: long-term outcomes. Surg Endosc. 2004;18:281–9.

    Article  CAS  PubMed  Google Scholar 

  5. D’Annibale A, et al. Robotic and laparoscopic surgery for treatment of colorectal diseases. Dis Colon Rectum. 2004;47:2162–8.

    Article  PubMed  Google Scholar 

  6. Park JS, et al. Robotic-assisted versus laparoscopic surgery for low rectal cancer: case-matched analysis of short term outcomes. Ann Surg Oncol. 2010;17:3195–202.

    Article  PubMed  Google Scholar 

  7. Maseo S, et al. Efficacy of the Da Vinci surgical system in abdominal surgery compared with that of laparoscopy: a systemic review and meta-analysis. Ann Surg. 2010;252(2):254–62.

    Article  Google Scholar 

  8. DeLaney CP, Senagore AJ, et al. Clinical outcomes and resource utilization associated with laparoscopic and open colectomy using a large national database. Ann Surg. 2008;247(5):819–24.

    Article  PubMed  Google Scholar 

  9. Nelson H, Petrelli N, Carlin A, et al. Guidelines 2000 for colon and rectal cancer surgery. J Natl Cancer Inst. 2001;93(8):583–96.

    Article  CAS  PubMed  Google Scholar 

  10. Adamina M, Champagne BJ, Hoffman L, et al. Randomized clinical trial comparing the cost and effectiveness of bipolar vessel sealers versus clips and vascular staplers for laparoscopic colorectal resection. Br J Surg. 2011;98(12):1703–12.

    Article  CAS  PubMed  Google Scholar 

  11. Person B, Vivas DA, Ruiz D, et al. Comparison of four energy-based vascular sealing and cutting instruments: a porcine model. Surg Endosc. 2008;22(2):534–8.

    Article  PubMed  Google Scholar 

  12. Jones OM, Smeulders N, Wiseman O, Miller R. Lateral ligaments of the rectum: an anatomical study. Br J Surg. 1999;86:487–9.

    Article  CAS  PubMed  Google Scholar 

  13. Takahashi T, Ueno M, Azekura K, Ohta H. Lateral node dissection and total mesorectal excision for rectal cancer. Dis Colon Rectum. 2000;43(10):S59–68.

    Article  CAS  PubMed  Google Scholar 

  14. Lindsey I, Guy RJ, Warren BF, Mortenson NJ. Anatomy of Denonvilliers’ fascia and pelvic nerves, impotence, and implications for the colorectal surgeon. Br J Surg. 2000;87:1288–99.

    Article  CAS  PubMed  Google Scholar 

  15. Kim JS, Cho SY, Min BS, et al. Risk factors for anastomotic leakage after laparoscopic intracorporeal colorectal anastomosis with a double stapling technique. J Am Coll Surg. 2009;209(6):694–701.

    Article  PubMed  Google Scholar 

  16. Ricciardi R, Roberts PL, Marcello PW, et al. Anastomotic leak testing after colorectal resection: what are the data? Arch Surg. 2009;144(5):407–11.

    Article  PubMed  Google Scholar 

  17. Joo JS, Latulippe JF, Alabaz O, et al. Long-term functional evaluation of straight coloanal anastomosis and colonic J-pouch: is the superiority of colonic J-pouch sustained? Dis Colon Rectum. 1998;41(6):740–6.

    Article  CAS  PubMed  Google Scholar 

  18. Lustosa SA, Matos D, Atallah AN, Castro AA. Stapled versus handsewn methods for colorectal anastomosis surgery. Cochrane Database Syst Rev. 2001;(3):CD003144.

    Google Scholar 

  19. Jayne DG, Guillou PJ, Thorpe H, Quirke P, Copeland J, Smith AM, et al. Randomized trial of laparoscopic-assisted resection of colorectal carcinoma: 3-year results of the UK MRC CLASICC trial group. J Clin Oncol. 2007;25(21):3061–8.

    Article  PubMed  Google Scholar 

  20. Swellengrebel HAM, Marijnen CAM, Verwaal VJ, Vincent A, et al. Toxicity and complications of preoperative chemoradiotherapy for locally advanced rectal cancer. Br J Surg. 2011;98:418–26.

    Article  CAS  PubMed  Google Scholar 

  21. Dr U, Kennedy ED, Cohen MM. Colon and rectal anastomoses do not require routine drainage: a systematic review and meta-analysis. Ann Surg. 1999;229(2):174–80.

    Article  Google Scholar 

  22. Heald RJ. The ‘holy plane’ of rectal surgery. J R Soc Med. 1988;81:503–8.

    PubMed Central  CAS  PubMed  Google Scholar 

  23. Masui H, Ike H, Yamaguchi S, et al. Male sexual function after autonomic nerve-preserving operation for rectal cancer. Dis Colon Rectum. 1996;39(10):1140–5.

    Article  CAS  PubMed  Google Scholar 

  24. Miles WE. A method of performing abdomino-perineal excision for carcinoma of the rectum and of the terminal portion of the pelvic colon. Lancet. 1908;ii:1812–3.

    Article  Google Scholar 

  25. Guillou PJ, Quirke P, Thorpe H, et al. Short-term endpoints of conventional versus laparoscopic-assisted surgery in patients with colorectal cancer (MRC CLASSIC trial): multicentre, randomized controlled trial. Lancet. 2005;365(9472):1718–26.

    Article  PubMed  Google Scholar 

  26. West NP, Finan PJ, Anderin C, Lindholm J, Holm T, Quirke P. Evidence of the oncologic superiority of cylindrical abdominoperineal excision for low rectal cancer. J Clin Oncol. 2008;26(21):3517–22.

    Article  PubMed  Google Scholar 

  27. D’Hoore A, Cadoni R, Penninck F. Long term outcome of laparoscopic ventral rectopexy for total rectal prolapse. Br J Surg. 2004;91:1500–5.

    Article  PubMed  Google Scholar 

  28. Madbouly KM, Senagore AJ, Delaney CP, Duepree HJ, Brady KM, Fazio VW. Clinically based management of rectal prolapse. Comparison of the laparoscopic Wells procedure and laparoscopic resection with rectopexy. Surg Endosc. 2003;17:99–103.

    Article  CAS  PubMed  Google Scholar 

  29. D’Hoore A, Penninckx F. Laparoscopic ventral recto(colpo)pexy for rectal prolapse: surgical technique and outcome for 109 patients. Surg Endosc. 2006;20:1919–23.

    Article  PubMed  Google Scholar 

  30. Wells C. New operation for rectal prolapse. Proc R Soc Med. 1959;52:602.

    PubMed Central  CAS  PubMed  Google Scholar 

  31. Ripstein CB. Treatment of massive rectal prolapse. Am J Surg. 1952;83:69–71.

    Article  Google Scholar 

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Author information

Authors and Affiliations

  1. Division of Colorectal Surgery, Keck Hospital of the University of Southern California, Los Angeles, CA, USA

    Kyle G. Cologne MD

  2. Department of Surgery, Central Michigan University, School of Medicine, Saginaw, MI, USA

    Anthony J. Senagore MD, MS, MBA

Authors
  1. Kyle G. Cologne MD
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  2. Anthony J. Senagore MD, MS, MBA
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Corresponding author

Correspondence to Kyle G. Cologne MD .

Editor information

Editors and Affiliations

  1. Division of Colon and Rectal Surgery, Department of Surgery, University of Nevada School of Medicine, Las Vegas, Nevada, USA

    Ovunc Bardakcioglu

Electronic Supplementary Material

Below is the link to the electronic supplementary material.

Laparoscopic total mesorectal excision (TME) (MP4 139118 kb)

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Cologne, K.G., Senagore, A.J. (2015). Proctectomy and Rectopexy: Laparoscopic Approach. In: Bardakcioglu, O. (eds) Advanced Techniques in Minimally Invasive and Robotic Colorectal Surgery. Springer, Boston, MA. https://doi.org/10.1007/978-1-4899-7531-7_17

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  • DOI: https://doi.org/10.1007/978-1-4899-7531-7_17

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  • Publisher Name: Springer, Boston, MA

  • Print ISBN: 978-1-4899-7530-0

  • Online ISBN: 978-1-4899-7531-7

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