Laparoscopic intersphincteric resection for low rectal cancer - a video vignette.

Sahebally, S M; McKevitt, K; El-Masry, S

The last two decades has seen a significant evolution in the surgical management of distal rectal cancer, with restoration of intestinal continuity now one of the primary objectives. The re-appraisal of the surgical distal clear margin from 5cm to ≤ 2cm, together with the advent of neoadjuvant chemoradiotherapy-induced tumour downstaging, has led to a decrease in abdominoperineal excision rates and a corresponding increase in sphincter-preserving procedures. An intersphincteric resection (ISR) proceeds in the space between the internal and external anal sphincters affording sphincter-preservation for low rectal cancer, avoidance of a permanent stoma, and with acceptable oncological outcomes. Laparoscopic ISR has been shown to be equivalent to robotic-assisted ISR with regards to postoperative morbidity and pathological outcomes. This article is protected by copyright. All rights reserved.