Preservation of inferior mesenteric vessels. Laparoscopic sigmoidectomy for cancer - a video vignette.

Laparoscopic sigmoidectomy is a well standardized procedure and offers excellent early and late results with low risk of recurrence and metastasis despite the significant risk of anastomotic leakage due to compromised blood supply through ligation of inferior mesenteric artery (IMA). Whether high or low IMA ligation should be performed remains controversial due to oncological reasons, vascular supply of the distal stump and lymph nodes harvested. Recently, Left Colic Artery (LCA) preservation with lymph node dissection of IMA root during laparoscopic surgery for early rectosigmoid cancer has been proposed to avoid leaks ensuring an adequate lymph node harvest [1].