Intraoperative accidents and countermeasures in laparoscopic pelvic exenteration        TANG Jian-qiang, ZHUANG Meng. Department of Colorectal Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
Corresponding author: TANG Jian-qiang,E-mail：doc_tjq@
hotmail.com
Abstract    The surgeon performing laparoscopic pelvic exenteration for rectal cancer must face the double challenge of pelvic anatomy cognition and laparoscopic techniques. The surgeon must master multidisciplinary knowledge such as colorectal surgery, uroloy, gynecology, orthopedics and plastic surgery thus could quickly identify important anatomical landmarks in complex scenes. The surgeon should pay attention to intraoperative accidents not only involve bleeding, bowel injury or pelvic plexus injury as conventional laparoscopic rectal surgery, but also accidents in the lateral pelvic space, including internal iliac vessel bleeding, ureteral injury, obturator nerve，and even lumbosacral trunk injury. At the same time, the risk of intraoperative accidents in the anterior pelvic space: bladder triangle injury, dorsal venous complex bleeding，and internal reproductive organ damage in female patients should also be attracted enough attention.