Arteries / surgery ; Collateral Ligaments* ; Humans ; Laparoscopy* / methods ; Pelvis / innervation ; Pelvis / surgery ; Rectal Neoplasms* / surgery ; Rectum / surgery
Keywords
Rectal cancer surgery ; deep anterolateral dissection ; gate approach to the pelvic floor ; total mesorectal excision
Abstract
Controversial surgical anatomical landmarks in the deep pelvis can be visualized and identified using current technologies. Performing the gate approach technique during deep lateral dissection for total mesorectal excision facilitates visualization of the pelvic neurovascular structures following simple dissection steps to preserve the pelvic autonomic nerves and avoid accidental vascular injuries. Here, we discuss laparoscopic exposure of an infrequent disposition of the middle rectal artery anterior to the lateral ligament of the rectum while performing the gate approach.