A View from the Shoulders of Giants: Using History to Optimize the Modern Minimally Invasive Proctectomy

Abstract

Minimally invasive surgery (MIS), including laparoscopic and robotic techniques, has helped improve visualization and ergonomic positioning for proctectomy surgeons within the narrow pelvic space. With increasing pressure to perform MIS, historical landmarks are essential for performing proctectomy in a way that minimizes tissue injury by efficiently dissecting along embryological planes. These landmarks, often named by pioneering physicians in their field, are easily lost when looking through the narrow lens of a laparoscope or robotic scope. For this review, a literature search was performed to provide context and a deeper understanding of the significance of each landmark and its importance in MIS. Therefore, a keen understanding of historical pelvic anatomy can help optimize the modern technique of an MIS proctectomy.