Consensus on Laparoscopic Low Anterior Resection Steps From Leading Surgeons in India

Dr. Shailesh Puntambekar; Dr. Jagadishwar Goud; Dr. Pradeep Jain; Dr. Rajesh Bhojwani; Dr. S. Ayyappan; Dr. Anil Heroor; Dr. Saumitra Rawat

Volume : IX, Issue : V, May - 2019

Consensus on Laparoscopic Low Anterior Resection Steps From Leading Surgeons in India

Dr. Shailesh Puntambekar, Dr. Jagadishwar Goud, Dr. Pradeep Jain, Dr. Rajesh Bhojwani, Dr. S. Ayyappan, Dr. Anil Heroor, Dr. Saumitra Rawat

Abstract :

The incidence of colorectal cancer in India is lower when compared with statistics globally. Rectal cancer is more prevalent in rural India than colon cancer. Though low anterior resection (LAR) provides better survival rate and improves quality of life in patients with rectal cancer, this laparoscopic colorectal surgery is difficult. Inexperienced surgeons face a lot of challenges during this procedure, such as difficulty in releasing the splenic flexure, releasing adhesions, releasing retroperitoneal fiosis, and identifying inferior mesenteric artery (IMA) in the thick mesocolon. The objective of this paper is to provide a unanimous guide for aspirant laparoscopic surgeons in understanding steps for LAR technique based on clinical evidences and expert opinions from leading surgeons in India. The paper describes in details the surgical aspects of LAR technique such as anatomic considerations, pre–operative care, patient positioning, access, repair, and closure