{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,2]],"date-time":"2026-02-02T22:40:26Z","timestamp":1770072026365,"version":"3.49.0"},"reference-count":20,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2015,1,21]],"date-time":"2015-01-21T00:00:00Z","timestamp":1421798400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Colorectal Disease"],"published-print":{"date-parts":[[2015,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aim<\/jats:title><jats:p>Nerve\u2010sparing surgery during laparoscopic rectal mobilization is still limited by anatomical constraints such as obesity, the narrowness of the male pelvis, an ultra low rectal cancer or all of these. The transanal approach for total mesorectal excision has overcome the shortcomings of limited access to the rectal \u2018no\u2010man's land\u2019 close to the pelvic floor. The aim of this anatomical study was to define a roadmap of anatomical landmarks for the caudal to cephalic approach so as to standardize nerve\u2010sparing rectal mobilization procedures.<\/jats:p><\/jats:sec><jats:sec><jats:title>Method<\/jats:title><jats:p>Macroscopic dissections of the pelvis in a caudal to cephalic direction were performed in eight alcohol\u2013glycerol embalmed cadavers. A roadmap of anatomical landmarks was created at different levels of section to demonstrate the sites of nerve injury.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Extrinsic autonomic nerves to the urogenital organs and the internal sphincter muscle are closely adjacent to the lowest portion of the rectum above the pelvic diaphragm.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>This anatomical guide for the pelvic surgeon should facilitate a safe and nerve\u2010sparing dissection of the mesorectal plane with a meticulous overview of the lowest autonomic nerve fibres. New anatomical insights by a \u2018caudal to cephalic\u2019 approach to the \u2018no\u2010man's land\u2019 should help overcome anatomical constraints of a narrow, obese and male pelvis during rectal mobilization procedures.<\/jats:p><\/jats:sec>","DOI":"10.1111\/codi.12846","type":"journal-article","created":{"date-parts":[[2014,11,24]],"date-time":"2014-11-24T03:48:42Z","timestamp":1416800922000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":34,"title":["Anatomical considerations for transanal minimal\u2010invasive surgery: the caudal to cephalic approach"],"prefix":"10.1111","volume":"17","author":[{"given":"F.","family":"Aigner","sequence":"first","affiliation":[{"name":"Department of Visceral, Transplant and Thoracic Surgery Innsbruck Medical University Innsbruck Austria"},{"name":"Department for General, Visceral and Transplantation Surgery Charit\u00e9 Universit\u00e4tsmedizin Berlin 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