Takuya Yamaguchi1, Minoru Imai, MD1, Dai Uematsu2. 1Mimihara General Hospital, 2Saku advanced care center
We treated a 64-year-old man for rectal cancer with direct invasion to the seminal vesicles and no distant metastases by complete resection with laparoscopy and transanal minimally invasive surgery (TAMIS). We inserted the TAMIS device into the anal canal to above the anorectal ring and dissected to prostate level. High ligation of inferior mesenteric artery and vein was performed by standard medial laparoscopy. Sigmoid and descending colon was mobilized, and in the postrectal space we dissected to the space made by TAMIS. Membranous peritoneum was dissected on both sides of the rectum to the cul-de-sac. Peritoneum was dissected anterolaterally to reveal the seminal ducts, which were ligated and dissected on both sides. Seminal vesicles were dissected from the posterior wall of the bladder to the prostate level. The rectal specimen was now fully mobilized. Lower rectal resection with combined laparoscopy and TAMIS provides a better surgical plane than standard laparoscopy.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 79521
Program Number: P202
Presentation Session: Poster (Non CME)
Presentation Type: Poster