After endoscopic diagnosis of rectal cancer with biopsies, pre-operative work-up consists of thoraco-abdominal CT-scan to assess local or distant metastatic lesions. Assessment of local tumour spread is performed by anal endo-rectal ultrasound and/or pelvic magnetic resonance imaging (MRI). In cases of advanced rectal cancer, radio-chemotherapy is advised before surgical resection. Laparoscopic robotic surgical resection of the rectum with total mesorectal resection (TME), creation of a colonic J-pouch with temporary protective ileostomy is then advised.
ta-TME with colo-anal anastomosis
ta-TME with colo-rectal anastomosis
Laparoscopic abdominoperineal resection
TME robotic rectal resection
J-pouch colo-anal anstomosis
Robotic rectal resection with TME