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Updated: May 31, 2025
Robot-assisted Total Mesorectal Excision and Lateral Pelvic Lymph Node Dissection for Locally Advanced Middle-low Rectal Cancer
Published on: February 12, 2022
Lateral pelvic lymph node dissection (LPLND) in the treatment of rectal cancer: current practice and evolving
Ankit Sharma1, Subhathira Manohkaran1, Avanish Saklani2
1Colorectal Division, Department of Surgical Oncology, Tata Memorial Hospital, Mumbai, India.
Background:
The introduction of total mesorectal excision improved locoregional control for rectal adenocarcinoma significantly. Standardisation of the technique of LPLND is lacking in literature.
Methods:
We describe the current practices of case selection and technical details of lateral lymph node dissection in rectal cancer. We also describe the approach when post neo-adjuvant fibrosis renders standard resection unsafe.
Results:
Careful case selection and standardisation of the lateral lymph node dissection technique is important to ensure an oncologically sound and surgically procedure . Step-by-step procedures of LPLND are described in this article, and a video is demonstrated.
Conclusions:
Standardisation of the techniques of lateral lymph node dissection is essential. The procedure has a definite learning curve, requiring considerable expertise to avoid complications and achieve optimal outcomes.
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