Two-Team Lateral Pelvic Lymph Node Dissection Assisted By the Transanal Approach

Area of Science:

• Surgical Oncology
• Colorectal Surgery
• Minimally Invasive Surgery

Background:

• Lateral pelvic lymph node dissection (LPLND) is crucial for advanced rectal cancer but technically challenging.
• The transanal approach for total mesorectal excision (TME) is gaining traction.
• Integrating LPLND with transanal TME offers potential benefits.

Observation:

• A two-team approach was utilized, entering the lateral pelvic area transanally.
• Dissection involved separating fatty tissues from pelvic structures and vessels.
• The obturator nerve was preserved while vessels were resected.

Findings:

• The two-team method significantly reduced operative time and surgeon strain.
• Transanal assistance facilitated secure and effective dissection, particularly in distal areas.
• This approach enhances dissection around critical vessels like the internal pudendal and inferior vesical arteries.

Implications:

• This combined technique offers a safe and effective method for LPLND in rectal cancer.
• It may improve outcomes for patients requiring advanced rectal cancer surgery.
• This technical note highlights a valuable advancement in surgical strategy for rectal cancer treatment.