Surgical anatomy of lateral lymph node dissection: landmarks and areas of dissection in minimally invasive surgery.

Lateral lymph node dissection (LLND) for rectal cancer is a vital procedure to achieve en bloc removal of metastatic lateral lymph nodes with surrounding fat tissues, guided by precise anatomical landmarks. The anatomy of the lateral compartment, however, is not straightforward for the majority of surgeons. Inadequate knowledge of the vascular and neural anatomy may increase the risk of intraoperative complications such as bleeding, nerve injury and incomplete lymph node dissection. Minimally invasive surgery provides enhanced visualization of the surgical anatomy in the lateral compartment. Comprehensive knowledge of surgical anatomy is indispensable for successful LLND, and  simplifying the anatomy into the planes makes the procedure accessible for surgeons. This article  presents anatomical landmarks essential for standardizing the step-by-step procedures of LLND and review the literature. i.e., for safe implementation of the procedures.