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Updated: Feb 6, 2026

Robot-assisted Total Mesorectal Excision and Lateral Pelvic Lymph Node Dissection for Locally Advanced Middle-low Rectal Cancer
Published on: February 12, 2022
Exploring minimally invasive options: Laparoscopic transabdominal levator transection for low rectal cancers
Fadl H Veerankutty1, Sidharth Chacko1, Vipin I Sreekumar1
1Department of GI and HPB Surgery, Aster Medcity, Kochi, Kerala, India.
Abstract:
Extralevator abdominoperineal excision (ELAPE) of the rectum offers wider circumferential margin and decreased rate of intraoperative tumour perforation. However, the need to change the position of the patient in between abdominal and perineal stages of the procedure and extended perineal resection result in increased morbidity and operative time. Evolving technique of laparoscopic transabdominal controlled division of levator ani muscles under direct vision could address these issues while providing all benefits of ELAPE for patients with low rectal cancers.
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