PDF | On Apr 1, , JUAN J GALLARDO R and others published Hemicolectomía izquierda a tres trócares: Técnica quirúrgica. Hemicolectomia izquierda Robert M. Zollinger,Zollinger’sAtlas of SurgicalOperations, Robert M. Zollinger, Jr. and E. Christopher Elliso. Transcript of hemicolectomia derecha. El colon. Lig. Nefrocólico: fija ángulo hepático y cubre riñón derecho, duodeno y porta. •LigFrenocólico.
|Published (Last):||9 August 2015|
|PDF File Size:||3.24 Mb|
|ePub File Size:||12.96 Mb|
|Price:||Free* [*Free Regsitration Required]|
El cirujano usa un abordaje superior para movilizar del colon izquierdo. What is the proportion of patients that you operate on laparoscopically? We present a laparoscopic sigmoidectomy in an obese patient using the AirSeal device.
This trocar uses a different approach: In this live interactive surgery, Dr. Serra-Aracil presents a laparoscopic sigmoid resection for recurrent complicated sigmoid diverticulitis. In America, what are the guidelines and recommendations for the laparoscopic treatment of colorectal cancers? Totally laparoscopic splenic flexure resection for cancer.
The objective of this video is to demonstrate a laparoscopic segmental oncological splenic flexure colonic resection for cancer. It is associated with a high risk of obstruction and a poor prognosis. The surgical approach is challenging and not fully standardized. The resected area must include the mesocolon with major vessels ligation at their origin, in order to reduce local recurrence via the complete removal of potentially involved lymph node stations.
The oncological effectiveness of a segmental resection could be determined by the peculiar lymphatic spread of splenic flexure cancers.
Different studies showed that the majority of positive lymph nodes among patients with splenic flexure carcinoma are distributed along the paracolic arcade and the left colic artery.
As a result, a segmental resection associated with a medial-to-lateral approach could be safe and effective. The experience with a totally laparoscopic approach with intracorporeal hemicolecomia is well described in the current literature.
Additionally, an intracorporeal anastomosis minimizes the risk of bowel twisting, preventing the exteriorization of the stumps, and reducing bowel traction, which can affect anastomotic irrigation, especially in obese patients. In a setting of surgeons experienced with laparoscopic colorectal surgery, the outcomes of laparoscopic segmental resection of splenic flexure are similar to those of laparoscopic resections for cancer in other locations.
This video demonstrates the dissection of the vascular anatomy of the right colon for a right hemicolectomy. The surgeon uses a medial approach to mesenteric mobilization to show an excellent dissection of ileocolic, right and middle colic vessels. Laparoscopic left hemicolectomy in a thin patient, including anastomotic control using intraoperative fluorescence. Obesity is associated with a more complex surgery and a longer operative time due to difficulties in finding the right plane of dissection and identifying the structures.
However, treating a thin patient may also be dangerous because the planes of dissection are more adherent, which makes it harder to identify hemicolectomiw real embryological dissection plane.
hemicolectomia derecha by Blanca Azucena Martinez on Prezi
The nightmare of colon and rectum surgery is the leak of the anastomosis. It may occur also with all precaution: Single incision laparoscopic-assisted right hemicolectomy for a izquietda cancer.
Single port operations are usually presented for appendectomies and cholecystectomies. A CT-colonography identified a caecal tumor, which was proven malignant by biopsies taken at a subsequent colonoscopy. Radiologically, this appeared to be an early T3 N0 tumor.
Because of his favorable body habitus and well-localized lesion, we elected to perform his laparoscopic-assisted right hemicolectomy by a single port technique.
Laparoscopic total colectomy with partial proctectomy.
This video demonstrates the performance of a total colectomy performed laparoscopically that included resection of the cephalad portion of the rectum. This approach involves resection hemixolectomia the proximal portion of the rectum.
The authors divide the ileum near the ileocecal junction.
With the ureter identified and secured, they move to dissect anterior to the fascia. The duodenum comes into view, then progressively the colon and attachments are freed.
There was a problem providing the content you requested
APE and nerve preservation. Rectal cancer surgery is impaired by a high rate of postoperative sexual dysfunction, cause of frequent nerve injuries. In this lecture, Professor RJ Heald details all the key steps when performing rectal resection.