Laparoscopic abdominoperineal excision of the rectum with high ligation of the inferior mesenteric artery in the management of rectal carcinoma.

Extended lymph node dissection, creation of a safe anastomosis and specimen retrieval pose the greatest problems in laparoscopic colorectal surgery. A safe technique for the performance of extended lymph node dissection with high vessel ligation has been developed on the basis of experimental studies. Abdominoperineal excision of the rectum is ideal for laparoscopic colorectal surgery because this procedure requires no anastomosing, and the specimen is retrieved perianally. From January to August 1992, we performed a laparoscopic excision of the rectum with high ligation of the inferior mesenteric artery in ten patients with low carcinomas. This paper presents clinical and technical data.