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Ke et al. Mini-invasive Surg 2018;2:35 Mini-invasive Surgery
DOI: 10.20517/2574-1225.2018.46

Review Open Access

The role of splenic flexure mobilization in
laparoscopic rectal surgery for rectal cancer

Tao-Wei Ke, Christian Ross Geniales, William Tzu-Liang Chen

Department of Colorectal Surgery, China Medical University Hospital, Taichung 404, Taiwan.

Correspondence to: Prof. William Tzu-Liang Chen, Department of Colorectal Surgery, China Medical University Hospital,
Taichung 404, Taiwan. E-mail: golfoma22@gmail.com

How to cite this article: Ke TW, Geniales CR, Chen WTL. The role of splenic flexure mobilization in laparoscopic rectal surgery
for rectal cancer. Mini-invasive Surg 2018;2:35. http://dx.doi.org/10.20517/2574-1225.2018.46
Received: 5 Jul 2018 First Decision: 20 Aug 2018 Revised: 24 Aug 2018 Accepted: 29 Aug 2018 Published: 9 Oct 2018

Science Editor: Gordon N. Buchanan Copy Editor: Yuan-Li Wang Production Editor: Huan-Liang Wu

Abstract
Laparoscopic surgery for the treatment of colorectal cancer has gained an enormous advantage as compared to the
traditional approach in terms of patient benefits. Although it has gained popularity among surgeons, there are still
some contentious issues especially in laparoscopic rectal surgery. Splenic flexure mobilization is a crucial aspect of the
procedure with complex technical details thereby establishing a learning curve that cannot be easily overcome. A team
of colorectal surgeons at China Medical University Hospital adopted a standardized approach to laparoscopic rectal
surgery particularly simplifying the steps involved in mobilizing the splenic flexure which is deemed as one of the difficult
steps in the surgery.

Keywords: Splenic flexure mobilization, anterior resection, low anterior resection, laparoscopic rectal surgery

INTRODUCTION
One of the most commonly diagnosed malignancies in the world is colorectal cancer (CRC). It currently
ranks third based on the GLOBOCAN (Global Cancer Incidence, Mortality and Prevalence) index and
is also the fourth leading cause of cancer-related deaths. The cancer burden will be increasing by 60% to
[1]
more than 2.2 million new cases and resulting in 1.1 million deaths by 2030 . Based on the National Can-
cer Registry of Taiwan, CRC is the second most common invasive neoplastic disease with a total of 15,764
[2]
cases in 2014 and a crude incidence rate of 67.27% . The evolution of laparoscopic-assisted compared to
open approach colorectal surgery for diverticular disease and cancer was first introduced in the early
1990s and was aimed to offer the benefit of less trauma, without compromising functional and oncological
[3]
outcomes . Laparoscopic surgery has gained increasing interest for the treatment of CRC. Laparoscopic
© The Author(s) 2018. Open Access This article is licensed under a Creative Commons Attribution 4.0
International License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use,
sharing, adaptation, distribution and reproduction in any medium or format, for any purpose, even commercially, as long
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