Intraoperative ultrasonic navigation for laparoscopic colorectal surgery with preservation of the left colic artery

Excerpt

Laparoscopic surgery has been widely performed for patients with advanced colorectal cancer. In curatively intended resection of sigmoid and rectal cancer, high ligation of the inferior mesenteric artery (IMA) is considered necessary for wide lymph node dissection. This also enables anastomosis to be performed in the pelvis without tension and contributes to the accuracy of tumor staging [1]. However, ligation of the IMA has been known to decrease blood flow to the anastomosis [2, 3]. Whether insufficient blood supply of the proximal colon limb could increase the leakage rate is uncertain but likely, and some surgeons prefer to perform a technique of lymph node dissection around the IMA with preservation of the IMA and left colic artery (LCA) [4]. This technique is technically demanding due to the anatomical features of the IMA and LCA. …