LOW ANTERIOR RESECTION (LAR) WITH TOTAL MESORECTAL EXCISION (TME)
Indication: Carcinoma of the middle or upper rectum (T2/T3) following neoadjuvant chemoradiotherapy where sphincter preservation is achievable. Distal margin of at least 1 cm required.
Patient Position: Lloyd-Davies (lithotomy with Trendelenburg).
Anaesthesia: General (with or without epidural).
Prophylactic Antibiotics: Per protocol.
Incision: Midline laparotomy (or laparoscopic approach).
Procedure:
1. Abdomen entered and explored. Liver inspected.