Title: Management of Intraoperative Complication During Laparoscopic Proctectomy for Submucosal Rectal Tumor

INTRODUCTION: This video demonstrates a laparoscopic proctectomy in a 51 year old female who presented with a symptomatic sub-mucosal anterior rectal lesion suspected of being a GIST tumour. The video illustrates work up, operative technique, and laparoscopic management of this patient; including two intra-operative complications that occurred during the pelvic dissection.
PROCEDURE: This case presentation demonstrates the key steps of a laparoscopic proctectomy with total meso-rectal excision, including high ligation of the inferior mesenteric artery and vein and complete mobilization of the splenic flexure. Restoration of intestinal continuity was performed with a colonic J pouch anal anastomosis. The video also describes how to recognize and manage two intra-operative complications that occurred during the pelvic dissection, specifically a vaginal perforation that occurred during a difficult anterior rectal dissection, and a misfiring of an endo-gia linear stapler during low transection of the rectum. Finally, we review the surprising pathological finding.


Session: Podium Video Presentation

Program Number: V014

« Return to SAGES 2009 abstract archive