Definitions of mesorectal surgery
Mesocolic - intact mesorectum with only minor irregularities of a smooth mesorectal surface. No defect is deeper than 5mm. No coning on the specimen. Smooth circumferential margin on slicing
Intramesocolic - Moderate bulk to mesorectum but irregularity of the mesorectal surface. Moderate coning of the specimen towards the distal margin. At no site is the muscularis propria visible (excluding sphincter area). Moderate irregularity of the circumferential resection margin.
Muscularis propria - Little bulk to the mesorectum with defects down onto the muscularis propria and/or very irregular circumferential resection margin.
Muscularis propria dissection
Poor mesorectal dissection down onto muscularis propria
Anterior intramesorectal dissection
Anterior surface irregular intramesorectal dissection
Mesorectal plane
Beautiful mesorectal excision showing the shiny fascia
Mesorectal plane dissection
Mesorectal excision showing shiny mesorectal surface
