Left Inferior Quadrant Oblique Incision: A New Access for Hand-Assisted Device During Laparoscopic Low Anterior Resection of Rectal Cancer

Abstract

Although long-term results are not clear, laparoscopic resection of rectal cancer may be feasible, and the use of hand-assisted technique may ease the procedure. This article aims to describe the details of left inferior quadrant oblique incision (LIQOI) and to discuss the results of patients who underwent laparoscopic hand-assisted low anterior resection using LIQOI. All rectal cancer patients who underwent a hand-assisted low anterior resection through a LIQOI at our department between November 2006 and May 2008 were retrospectively evaluated. The details of the procedures were assessed. At the time of laparoscopic rectal cancer surgery, LIQOI was used on 23 patients (13 males; 56.5%) with a mean age of 55.2; standard deviation was 12.8 years. Conversion to open surgery was necessitated in 1 patient (4.4%), who was suspected to have a T4 tumor, and another case (4.4%) with a severe cardiac illness died 7 days after surgery. The right and left hands were used to help the mobilization of splenic flexure and rectum, respectively, after the insertion of the hand-assisted device through LIQOI. This incision may allow the uncomplicated mobilization of splenic flexure and rectum and thus ease the hand-assisted low anterior resection procedure.