Combined Left Colic Artery Preservation and Inferior Mesentery Artery Lymph Node Dissection During Laparoscopic Low Anterior Resection

Sheng-chi Chang, MD, De-wei Ke, MD, William Tzu-liang Chen, MD. China Medical University Hospital,Taichung, Taiwan


During rectal surgery, management of inferior mesentery artery (IMA) can be divided in to high tie method and low tie method. High tie method means IMA was transected at base that caught harvest pedicle lymph nodes (LNs) and produced accurate cancer stage. Low tie means IMA was transected above left colic artery (LCA) that support better blood flow to the proximal colon stump. Most laparoscopic surgeon preferred high tie because the technique was easier than low tie method. However, our current method in doing IMA is combined laparoscopic low tie and IMA D3 LNs dissection that not only improved circulation of colon, but also clean all LNs. Since November 2010, we performed this method in most patient undergoing laparoscopic low anterior resection (LAR). I will introduce our standard flow procedure doing laparoscopic LAR with LCA preservation and D3 LNs dissection by video.

Session Number: Poster – Poster Presentations
Program Number: P621
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