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Laparoscopic extralevator abdominal perineal excision of the rectum: the best of both worlds

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Abstract

We report a combined laparoscopic and open technique for extralevator abdominal perineal excision of the rectum. The key steps are a laparoscopic rectal dissection limited distally by the coccyx. The open, prone, perineal dissection affords excellent views and allows a cylindrical specimen to be obtained. The resulting perineal defect is closed by a biological mesh. Extralevator abdominal perineal excision of the rectum offers a superior oncological specimen with reduced circumferential resection margin involvement compared to traditional techniques. Combined with a laparoscopic approach, this also has the potential to improve postoperative recovery and reduce morbidity.

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Conflict of interest

The biological mesh used for the case was provided free of charge. The authors have no other conflict of interest.

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Authors and Affiliations

  1. University Hospitals Leicester, Leicester, UK

    B. Singh, G. Lloyd & S. Chaudhri

  2. Karolinska University Hospital, Stockholm, Sweden

    P. J. Nilsson

Authors
  1. B. Singh
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  2. G. Lloyd
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  3. P. J. Nilsson
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  4. S. Chaudhri
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Corresponding author

Correspondence to B. Singh.

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Singh, B., Lloyd, G., Nilsson, P.J. et al. Laparoscopic extralevator abdominal perineal excision of the rectum: the best of both worlds. Tech Coloproctol 16, 73–75 (2012). https://doi.org/10.1007/s10151-011-0797-y

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  • DOI: https://doi.org/10.1007/s10151-011-0797-y

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