Laparoscopic lower anterior resection is equivalent to laparotomy for lower rectal cancer at the distal line of resection

Background: Procedures that involve resection of the distal rectum challenge the current limitations of laparoscopic technology, because of lack of compact articulating stapling instruments. Method: We improve the procedure with the aid of a Lap disk, an abdominal wall sealing device that was developed for hand-assisted manipulation. A linear stapler capable of changing its stop angle is inserted through the disk, and the rectum is transected by the disk during a second pneumoperitoneum. Results: The transection line becomes equivalent to that obtained with laparotomy. Conclusion: This new technique made laparoscopic lower anterior resection possible to transect the lower rectum in the same way as is done with laparotomy.