The anatomical significance and surgical dissection of Denonvilliers' fascia in laparoscopic and robotic total mesorectal excision
CHI Pan
WANG Xiao-jie
Abstract：To dissect in the pre-rectal space is a technically difficult procedure during laparoscopic and robotic total mesorectal excision.With the further understanding of surgical membrane anatomy and the relationship between Denonvilliers' fascia and neurovascular bundles (NVB),surgeons can identify and protect the NVB during dissecting in the pre-rectal space without oncological compromise.The article introduces a surgical technique of an individual dissection of Denonvilliers' fascia.Firstly,entering the pre-Denonvilliers space by cutting the peritoneum at 1 cm anterior and cranial to the peritoneal reflection.Secondly,entering the post-Denonvilliers space by a U-shaped cut of the anterior lobe of Denonvilliers' fascia at the inner side of NVB,and at 0.5 cm away from the bottom of seminal vesicles for males or 5 cm below the peritoneal reflection for females.
Keywords：laparoscopictotal mesorectal excisionDenonvilliers fascianeurovascular bundlesmembrane anatomy
Publication Date：2017-01-01
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：7( 609-615 )