Key Aspects of the Abdominal Dissection

Abstract

Modern gastrointestinal surgery has changed notably with respect to surgical modality since the advent of endoscopic surgery. The introduction of endoscopic surgery in rectal cancer treatment has enabled “better visualization of structures that could not be seen with conventional techniques,” especially in the deep areas of the narrow pelvic cavity. Good surgical operation under magnified vision that was not possible with laparotomy became possible. As a result, laparoscopic total mesorectal excision (TME) has now been standardized as a procedure for the treatment of rectal cancer. Several randomized comparative studies from around the world have recently been published that have shown that compared to laparotomy, laparoscopic surgery for rectal cancer is associated with certain concerns regarding the technique’s application toward curative-intent rectal resection. This shows that laparoscopic surgery is a complex surgical procedure requiring good surgical skills. Even when a magnified view is obtained under laparoscopic assistance, one cannot deny that restrictions remain in the manipulation of forceps and dissectors in the deep pelvic areas.