Abstract
BackgroundBetween April 2005 and December 2012, we performed laparoscopic colorectal resection with regional lymph node dissection on 273 cases of colorectal cancer patients. However, Laparoscopic rectal cancer surgery requires a high degree of skill. Any surgeon who is going to embark on these difficult resections should have at a minimum laparoscopic suturing skills in order to be able to close the peritoneal defect.MethodsIn laparoscopic surgery for rectal cancer, the intracorporeal suture technique required to close the pelvic cavity is very difficult. Barbed sutures have recently been proposed to facilitate laparoscopic suturing. Two patients with rectal cancer who underwent laparoscopic abdominoperineal resection (APR) with intracorporeal closure of the pelvic cavity from September to October 2012 were enrolled in this study.ResultsWe present our initial experience of two consecutive cases of intracorporeal closure of the pelvic cavity by totally laparoscopic APR. After clinical follow-up, the two patients have no complaints and have shown no signs of recurrence.ConclusionsWe hypothesized that barbed sutures could potentially improve the efficiency of intracorporeal closure of the pelvic cavity after laparoscopic APR. Further, we expect that use of the V-Loc™ will reduce intra-operative stress on the endoscopic surgeon.
Highlights
Between April 2005 and December 2012, we performed laparoscopic colorectal resection with regional lymph node dissection on 273 cases of colorectal cancer patients
The opinion stated in many studies is that it is unnecessary to close the pelvic cavity with laparoscopic abdominoperineal resection (APR)
We hypothesized that barbed sutures could potentially improve the efficiency of intracorporeal closure of the pelvic cavity after laparoscopic APR
Summary
Between April 2005 and December 2012, we performed laparoscopic colorectal resection with regional lymph node dissection on 273 cases of colorectal cancer patients. Laparoscopic rectal cancer surgery requires a high degree of skill. Any surgeon who is going to embark on these difficult resections should have at a minimum laparoscopic suturing skills in order to be able to close the peritoneal defect. Laparoscopic colectomy was first reported in 1991. Laparoscopic colectomy has been gradually accepted on the basis of its technical advantages, safety, and feasibility in many studies. Laparoscopic surgery for rectal cancer is still more complicated than laparoscopic colectomy, owing to its technical difficulty in the pelvis. In laparoscopic surgery for rectal cancer, the intracorporeal suture technique required to close the pelvic cavity is very difficult. The opinion stated in many studies is that it is unnecessary to close the pelvic cavity with laparoscopic abdominoperineal resection (APR). Most colorectal surgeons usually close the pelvic cavity via conversion laparotomy to prevent prolapse of the small intestine into the pelvic cavity
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