Laparoscopic lower anterior resection is equivalent to laparotomy for lower rectal cancer at the distal line of resection.
BACKGROUND
Procedures that involve resection of the distal rectum challenge the current limitations of laparoscopic technology, because of lack of compact articulating stapling instruments.


METHODS
We improve the procedure with the aid of a Lap disk, an abdominal wall sealing device that was developed for hand-assisted manipulation. A linear stapler capable of changing its stop angle is inserted through the disk, and the rectum is transected by the disk during a second pneumoperitoneum.


RESULTS
The transection line becomes equivalent to that obtained with laparotomy.


CONCLUSIONS
This new technique made laparoscopic lower anterior resection possible to transect the lower rectum in the same way as is done with laparotomy.
Ichihara
T
T
First Department of Surgery, Kobe University School of Medicine, Kobe, Japan.
Nagahata
Y
Y
Nomura
H
H
Fukumoto
S
S
Urakawa
T
T
Aoyama
N
N
Kuroda
Y
Y
D000009:Abdominal Muscles / Q000601:surgery; D004867:Equipment Design; D006801:Humans; D020706:Laparoscopes; D010535:Laparoscopy / Q000379:methods*; D007813:Laparotomy / Q000295:instrumentation / Q000379:methods*; D011028:Pneumoperitoneum, Artificial; D012004:Rectal Neoplasms / Q000601:surgery*; D012007:Rectum / Q000601:surgery*; D013528:Surgical Staplers