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Laparoscopic TME with low colorectal end-to-end anastomosis (stapled) and temporary ileostomy.
Clinical Case:
- 62 y.o. Male
- Mid-low rectal cancer – T3N+
- Preoperative chemoradiotherapy
- Surgery: laparoscopic TME with temporary ileostomy
Clinical History:
- Diagnosis of a mid-low rectal cancer, starting 3 cm above the anal verge
- Local staging with ultrasound and MRI – cT3N+
- CT-scan showed no distant metastasis
- Neoadjuvant treatment with chemoradiotherapy
Other History:
- No important medical history
- Surgical history: previous apendectomy
Procedure steps:
- 1. Surgical history: previous apendectomy
- 2. Splenic flexure mobilization with a medial-to-lateral approach
- 3. Inferior Mesenteric Artery (IMA) ligation
- 4. Medial-to-lateral approach with full colonic mobilization
- 5. TME
- 6. Circular stapled anastomosis
- 7. Temporary stoma (ileostomy)
Learning points:
- Medial approach for veins & arteries
- Radial dissection above the pancreas
- TME
