Difficult Laparoscopic Rectal Dissection

  • Deborah S. Keller
  • Scott R. Steele
  • Daniel P. Geisler


Pelvic surgery brings about additional potential difficulties due to the fixed bony pelvis and the adjacent vascular, neurologic, and genitourinary structures. Further, patient- and disease-related factors such as large tumors, obesity, prior radiation, inflammation, and recurrent disease make a laparoscopic approach technically demanding. Here we will review how to approach the rectal dissection via minimally invasive surgery.


Laparoscopy Rectal Proctectomy 

Suggested Reading

  1. 1.
    Champagne BJ, Delaney CP. Laparoscopic approaches to rectal cancer. Clin Colon Rectal Surg. 2007;20:237–48.CrossRefGoogle Scholar
  2. 2.
    Cima RR, Pattana-arun J, Larson DW, Dozois EJ, Wolff BG, Pemberton JH. Experience with 969 minimal access colectomies: the role of hand-assisted laparoscopy in expanding minimally invasive surgery for complex colectomies. J Am Coll Surg. 2008;206:946–50; discussion 950.CrossRefGoogle Scholar
  3. 3.
    Lindsetmo RO, Champagne B, Delaney CP. Laparoscopic rectal resections and fast-track surgery: what can be expected? Am J Surg. 2009;197:408–12.CrossRefGoogle Scholar
  4. 4.
    Rullier E, Sa Cunha A, Couderc P, Rullier A, Gontier R, Saric J. Laparoscopic intersphincteric resection with coloplasty and coloanal anastomosis for mid and low rectal cancer. Br J Surg. 2003;90:445–51.CrossRefGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • Deborah S. Keller
    • 1
  • Scott R. Steele
    • 2
    • 3
  • Daniel P. Geisler
    • 4
  1. 1.Department of SurgeryNew York-Presbyterian, Columbia University Medical CenterNew YorkUSA
  2. 2.Case Western Reserve University School of MedicineClevelandUSA
  3. 3.Department of Colorectal SurgeryCleveland ClinicClevelandUSA
  4. 4.NewYork-Presbyterian/Columbia, Department of Colorectal SurgeryNew YorkUSA

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