Autonomic Nerve-Preserving Total Mesorectal Excision in the Laparoscopic Era Export

@article{citeulike:3152229, abstract = {Abstract Purpose\ \ Although technically demanding, laparoscopy may be advantageous in magnifying the anatomy of the pelvic autonomic nervous system when performing total mesorectal excision for rectal cancer. We present our method for laparoscopic total mesorectal excision for men. Methods\ \ We performed laparoscopic total mesorectal excision for 36 men with middle or low rectal cancer. The rectum was mobilized through a medial approach down to the pelvic floor without minilaparotomy or hand assist. Anteriorly, the dissection plane was in front of Denonvilliers fascia. Anterolaterally, to preserve the pelvic plexus and neurovascular bundle, Denonvilliers fascia must be cut at its lateral continuity. We found that the most important factor in obtaining a good surgical view is keeping adequate tension in the dissection plane by coordination between the surgeon and assistant. Dissection was performed by using only electrocautery without an ultrasonic dissector or vessel sealing device. Results\ \ No case was converted to open surgery. The short-term feasibility was acceptable. Conclusions\ \ Our method of laparoscopic total mesorectal excision is a feasible approach and may be beneficial for the standardization and popularization of laparoscopic total mesorectal excision. Long-term results, including survival data and urogenital function, are needed to evaluate the true efficacy of this procedure.}, author = {Hasegawa, Suguru and Nagayama, Satoshi and Nomura, Akinari and Kawamura, Junnichiro and Sakai, Yoshiharu}, citeulike-article-id = {3152229}, citeulike-linkout-0 = {http://dx.doi.org/10.1007/s10350-008-9352-y}, day = {1}, doi = {10.1007/s10350-008-9352-y}, journal = {Diseases of the Colon \& Rectum}, number = {8}, pages = {1279--1282}, posted-at = {2008-08-24 20:19:32}, priority = {2}, title = {Autonomic Nerve-Preserving Total Mesorectal Excision in the Laparoscopic Era}, url = {http://dx.doi.org/10.1007/s10350-008-9352-y}, volume = {51}, year = {2008} }

TY - JOUR ID - citeulike:3152229 L3 - citeulike-article-id:3152229 N2 - Abstract Purpose  Although technically demanding, laparoscopy may be advantageous in magnifying the anatomy of the pelvic autonomic nervous system when performing total mesorectal excision for rectal cancer. We present our method for laparoscopic total mesorectal excision for men. Methods  We performed laparoscopic total mesorectal excision for 36 men with middle or low rectal cancer. The rectum was mobilized through a medial approach down to the pelvic floor without minilaparotomy or hand assist. Anteriorly, the dissection plane was in front of Denonvilliers fascia. Anterolaterally, to preserve the pelvic plexus and neurovascular bundle, Denonvilliers fascia must be cut at its lateral continuity. We found that the most important factor in obtaining a good surgical view is keeping adequate tension in the dissection plane by coordination between the surgeon and assistant. Dissection was performed by using only electrocautery without an ultrasonic dissector or vessel sealing device. Results  No case was converted to open surgery. The short-term feasibility was acceptable. Conclusions  Our method of laparoscopic total mesorectal excision is a feasible approach and may be beneficial for the standardization and popularization of laparoscopic total mesorectal excision. Long-term results, including survival data and urogenital function, are needed to evaluate the true efficacy of this procedure. IS - 8 JF - Diseases of the Colon & Rectum EP - 1282 TI - Autonomic Nerve-Preserving Total Mesorectal Excision in the Laparoscopic Era VL - 51 SP - 1279 AU - Hasegawa, Suguru AU - Nagayama, Satoshi AU - Nomura, Akinari AU - Kawamura, Junnichiro AU - Sakai, Yoshiharu PY - 2008//01/ UR - http://dx.doi.org/10.1007/s10350-008-9352-y ER -