title: Laparoscopic extralevator abdominal perineal excision of the rectum: the best of both worlds.
abstract: We report a combined laparoscopic and open technique for extralevator abdominal perineal excision of the rectum. The key steps are a laparoscopic rectal dissection limited distally by the coccyx. The open, prone, perineal dissection affords excellent views and allows a cylindrical specimen to be obtained. The resulting perineal defect is closed by a biological mesh. Extralevator abdominal perineal excision of the rectum offers a superior oncological specimen with reduced circumferential resection margin involvement compared to traditional techniques. Combined with a laparoscopic approach, this also has the potential to improve postoperative recovery and reduce morbidity.
authors.affiliation: University Hospitals Leicester, Leicester, UK. bs143@le.ac.uk
authors.forename: B
authors.initials: B
authors.lastname: Singh
authors.forename: G
authors.initials: G
authors.lastname: Lloyd
authors.forename: P J
authors.initials: PJ
authors.lastname: Nilsson
authors.forename: S
authors.initials: S
authors.lastname: Chaudhri
mesh_terms: D000005:Abdomen / Q000601:surgery*; D005260:Female; D006801:Humans; D010535:Laparoscopy; D008875:Middle Aged; D010502:Perineum / Q000601:surgery*; D012004:Rectal Neoplasms / Q000601:surgery*