Laparoscopic Sigmoidectomy with Preservation of the Superior Rectal Artery: Usefulness of Bipolar Scissors

Abstract

In D3 sigmoidectomy, the root of the inferior mesenteric artery (IMA) is usually divided. However, this sometimes causes insufficient blood supply at the anastomosis, leading to anastomotic leakage. We perform superior rectal artery (SRA)-preserving laparoscopic sigmoidectomy for proximal sigmoid colon cancer to preserve the blood supply to the anastomotic site. The vascular sheath along the IMA and the SRA were peeled off together with the lymph nodes using bipolar scissors, then the arteries feeding the tumor were divided at the bifurcation from the SRA. Forty patients underwent this operation, and there were no cases of intraoperative morbidity and none required conversion to laparotomy. There were 2 cases of bowel obstruction, 2 of pneumonia, 1 of pulmonary embolism, and 1 of wound infection; however, there were no cases of anastomotic leakage. Laparoscopic D2 or D3 sigmoidectomy with preservation of the SRA can be safely conducted with our technique using bipolar scissors.