175. Optimal surgical plans to perform total mesorectal excision, while ensuring nervous conservation – Clear-cut answers thanks to a 3D histological approach

Abstract

Introduction: Despite continuous surgical improvements, genito urinary sequelae remain frequent after rectal surgery for cancer. Total mesorectal excision is considered as the standard technique for oncological rectal surgery. However, relationships between pelvic nerves and surgical plans remain very unclear and subject to contradictory interpretations. Such knowledge and accurate 3D positioning is fundamental to expect an optimal nervous conservation after surgery. We studied the relationships between the inferior hypogastric plexus and the lateral fascia of the pelvis and between Denonvilliers' fascia and efferent branches of the IHP, and could give a comprehensive 3D representation of these different elements.