Technique of dissection in the pre-rectal space during laparoscopic total mesorectal excision

Abstract

It is a difficult procedure to dissect in the pre-rectal space during laparoscopic total mesorectal excision(TME). If the dissection was not in the right space, the fascia propria of the anterior rectal wall would be broken and damage the neurovascular bundles nearby. With regard to the tumor located in the anterior rectal wall, the broken fascia propria of the rectum may result in the involvement of the circumferential resection margin and local recurrence. And the damage of the neurovascular bundles would lead to post-operative sexual dysfunction, especially in the male. It is important for the surgeons to master the technique of dissection in the pre-rectal space, and it is helpful to improve the quality of TME and the quality of life of the patients after operations. Key words: Rectum; Laparoscopes; Dissection