Laparoscopic Low Anterior Resection and Total Mesorectal Excision

  • Katie E. SchwabEmail author
  • Timothy Rockall
Part of the Springer Surgery Atlas Series book series (SPRISURGERY)


All patients should receive preoperative counselling and preparation in line with Enhanced Recovery After Surgery (ERAS) guidelines. All patients should receive counselling about stoma formation and potential stoma sites should be marked appropriately before surgery. Ideally, preoperative stoma care training should be undertaken. The use of bowel preparation before rectal surgery remains controversial. Our policy is to administer full mechanical bowel preparation using sodium picosulphate or polyethylene glycol preparations for patients undergoing total mesorectal excision (TME) surgery or any anterior resection of the rectum when a defunctioning ileostomy is planned. Otherwise, a preoperative phosphate enema is administered to empty the rectum and left colon.


Laparoscopy TME Rectal resection Surgical technique 

Recommended Reading

  1. 1.
    Day AR, Smith RV, Jourdan IC, Rockall TA. Survival following laparoscopic and open colorectal surgery. Surg Endosc. 2013;27(7):2415–21.CrossRefGoogle Scholar
  2. 2.
    Miskovic D, Foster J, Agha A, Delaney CP, Francis N, Hasegawa H, et al. Standardization of laparoscopic total mesorectal excision for rectal cancer: a structured international expert consensus. Ann Surg. 2015;261(4):716–22.CrossRefGoogle Scholar
  3. 3.
    Nygren J, Thacker J, Carli F, Fearon KC, Norderval S, Lobo DN, et al. Enhanced recovery after surgery (ERAS) society, for perioperative care.; European Society for Clinical Nutrition and Metabolism (ESPEN).; International Association for Surgical Metabolism and Nutrition (IASMEN). Guidelines for perioperative care in elective rectal/pelvic surgery: enhanced recovery after surgery (ERAS) society recommendations. World J Surg. 2013;37(2):285–305.CrossRefGoogle Scholar
  4. 4.
    Vennix S, Pelzers L, Bouvy N, Beets GL, Pierie JP, Wiggers T, Breukink S. Laparoscopic versus open total mesorectal excision for rectal cancer. Cochrane Database Syst Rev. 2014;15:4.Google Scholar

Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.MATTU, Royal Surrey County HospitalGuildfordUK
  2. 2.Royal Bournemouth and Christchurch NHS Foundation TrustBournemouthUK

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