Intraoperative ultrasonography for identification of left colon tumor

The purpose of this video is to demonstrate a technique for the identification of intracolonic polyps during laparoscopy. Numerous techniques have been described, in particular ultrasonic-assisted identification for lesions of the distal colon and upper rectum. We use this identification technique in a patient with a polyp situated 40cm from the anal margin.

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Intraoperative ultrasonography for identification of left colon tumor

Authors

J Leroy, J Marescaux

Abstract

The purpose of this video is to demonstrate a technique for the identification of intracolonic polyps during laparoscopy. Numerous techniques have been described, in particular ultrasonic-assisted identification for lesions of the distal colon and upper rectum. We use this identification technique in a patient with a polyp situated 40cm from the anal margin.

Classification

tips and tricks

Keywords

Intraoperative ultrasonography, identification, left colon tumor

Media type

Surgical video

Duration

01'23''

Publication

2009-12

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E-publication

WeBSurg.com, Dec 2009;9(12).
URL: http://www.websurg.com/doi-vd01en2765.htm

Intraoperative ultrasonography for identification of left colon tumor

1. Introduction 00'10''

The purpose of this video is to demonstrate a technique for the identification of intracolonic polyps during laparoscopy. Numerous techniques have been described, in particular ultrasonic-assisted identification for lesions of the distal colon and upper rectum. We use this identification technique in a patient with a polyp situated 40cm from the anal margin. To do so, we clamp the colon following its mobilization and we fill the lumen of the colon with a saline serum solution.

2. Laparoscopic ultrasound probe introduction and polyp identification 00'39''

Then we introduce a laparoscopic ultrasound probe through a 12mm trocar situated in the right iliac fossa. The probe is passed above the colon and here we can clearly see two polypoid masses opposite to each other at a distance equivalent to that demonstrated by the endoscopy, that is at the top of the sigmoid loop. This bowel segment will be identified and we can either perform a very limited segmental resection or an extensive resection of the sigmoid. This is achieved in order to demonstrate the identification possibilities. The analysis of the specimen shows the two lesions situated opposite to each other as demonstrated by the intraoperative ultrasound and the presence of a clip positioned preoperatively by colonoscopy.