Application of laparoscopic locating surgical margin in sigmoidectomy- a video vignette

At present, the radical resection of sigmoid cancer follows the CME principle [1]. For invasive colonic cancer, the Japanese General Rules recommends en bloc resection with D3 lymphadenectomy. This involves meticulous mesocolonic resection with ligation of the primary feeding artery at its origin and resection of at least 10 cm of bowel proximal and distal to the tumour [2]. In the case of a sigmoid cancer, the site of the incision may be difficult to define. An incomplete resection may adversely effect the chance of a curative procedure. Conversely if the resection is too radical in terms of length, then an unnecessary splenic flexure mobilization may be needed which will add to the difficulty of the operation [3], This may lead to increased risk of anastomotic leak and stenosis [4].