Laparoscopic low anterior resection for rectal cancer.

More so than with other types of colon cancer, rectal cancer is associated with a range of laparoscopic surgical techniques. Treatment of cancer of the lower rectum requires favorable operative fields, minimal contact with the tumor during dissection, and delicate surgical procedures to avoid nerve damage. Such surgery thus requires immobilizing the trunk so the patient can be repositioned as needed, placing ports at appropriate locations, as well as careful handling of surgical equipment. To minimize the risk of disseminating cancer cells during the procedure, the surgery should be restricted to patients with early-stage cancer. The most difficult surgical procedure is resection of the lower rectum. While safe resection of the intestinal tract was difficult using previously available surgical equipment, newly developed equipment makes today's resections much safer and easier. Indications for surgical intervention should be broadened carefully, based on a deeper understanding of the surgical anatomy within the pelvis and on various relevant oncological and technical factors.