Fig. 2

Case 2: a case of middle rectal cancer without any postoperative complications. a Preoperative computed tomography (CT)-colonography shows the PDM. The black arrow shows middle rectal cancer. b Preoperative CT-angiography. The white arrow shows that the left colonic artery (LCA) branched from the inferior mesenteric artery (IMA). c During laparoscopic surgery, the superior rectal artery (SRA) was cut (white dotted arrow) while preserving the LCA (white arrow). d Infrared ray (IR) imaging using indocyanine green (ICG) performed prior to the anastomosis. The picture was taken after the rectal transection of the anal side of the tumor. After the transection, oral side of the colon with the tumor was pulled out from the umbilicus, and ICG (3 ml, 7.5 mg) was injected. ICG fluorescence imaging using a near-infrared camera system showed good blood flow of the reconstructing colon at the estimated cut line (white dotted line). e Postoperative CT-angiography. The white arrow shows the preserved LCA. The white dotted arrows show the clips on the SRA (left) and inferior mesenteric vein (IMV) (right)