Total mesorectal excision - does the choice of dissection technique have an impact on pelvic autonomic nerve preservation?

Background The aim of this experimental study was to assess the quality of pelvic autonomic nerve preservation of different dissection techniques.

Continuous intraoperative monitoring of pelvic autonomic nerves as a microtechnological navigation instrument

Total mesorectal excision with intraoperative assessment of internal anal sphincter innervation provides new insights into neurogenic incontinence

Background: The aim of this prospective study was to assess internal anal sphincter (IAS) innervation in patients undergoing total mesorectal excision (TME) by intraoperative neuromonitoring (IONM). Study Design: Fourteen patients underwent TME. IONM was carried out through pelvic splanchnic nerve stimulation under continuous electromyography of the IAS. Anorectal function was assessed with the digital rectal examination scoring system and a standardized questionnaire. Results: Nine of 11 patients who underwent low anterior resection had positive IONM results, with stimulation-induced increased IAS electromyographic amplitudes (median 0.23 V (interquartile range [IQR] 0.05, 0.56) vs median …