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Jeong-Heum BAEK

City of Hope National Medical Center
Duarte, Соединенные Штаты
MD
129 лайков
5.2K просмотров
1 комментарий
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Totally laparoscopic right hemicolectomy with transvaginal specimen extraction
We present our technique for totally laparoscopic right colectomy for locally advanced colon cancer with transvaginal specimen extraction. The patient was a 73-year-old female who presented with a biopsy proven cecal adenocarcinoma. We performed a right hemicolectomy using a 4 port approach with the patient in modified lithotomy position. Medial to lateral mobilization and early high ligation of the ileocolic pedicle were performed. The resected specimen was placed in a large retrieval bag.
With the patient positioned in modified lithotomy, a posterior culpotomy was made and the specimen removed intact through the vagina. The culpotomy was closed from the vaginal approach. A 60mm stapled side-to-side anastomosis was created intracorporeally to complete the procedure. The specimen was 52cm in length and contained a 3.2cm tumor and 13 lymph nodes. The patient's pathologic stage was T3N1.
Хирургические операции
9 лет назад
4492 просмотров
103 лайков
0 комментариев
08:30
Totally laparoscopic right hemicolectomy with transvaginal specimen extraction
We present our technique for totally laparoscopic right colectomy for locally advanced colon cancer with transvaginal specimen extraction. The patient was a 73-year-old female who presented with a biopsy proven cecal adenocarcinoma. We performed a right hemicolectomy using a 4 port approach with the patient in modified lithotomy position. Medial to lateral mobilization and early high ligation of the ileocolic pedicle were performed. The resected specimen was placed in a large retrieval bag.
With the patient positioned in modified lithotomy, a posterior culpotomy was made and the specimen removed intact through the vagina. The culpotomy was closed from the vaginal approach. A 60mm stapled side-to-side anastomosis was created intracorporeally to complete the procedure. The specimen was 52cm in length and contained a 3.2cm tumor and 13 lymph nodes. The patient's pathologic stage was T3N1.
Totally robotic low anterior resection (RLAR) with trans-anal specimen extraction and single stapling technique
We present the case of a 76-year-old woman with a low rectal cancer (T3N0 at 7cm) status post-chemoradiation therapy. Using a four-arm DaVinci system, we carry out the dissection in a medial to lateral fashion dividing the inferior mesenteric vessels and mobilizing the splenic flexure. A total mesorectal excision is performed to the level of the pelvic floor. The specimen is delivered through a wound protector covering the anus. The sigmoid colon is divided extracorporeally, an anvil is secured. Using robotic instruments, a purse-string is sutured to the rectal stump and tied around the EEA stapler spike. An end-to-end anastomosis is created under vision. A diverting ileostomy is performed. This novel robotic procedure eliminates the need for an incision for specimen extraction and may facilitate transection of the rectum during RLAR.
Хирургические операции
9 лет назад
746 просмотров
26 лайков
0 комментариев
10:50
Totally robotic low anterior resection (RLAR) with trans-anal specimen extraction and single stapling technique
We present the case of a 76-year-old woman with a low rectal cancer (T3N0 at 7cm) status post-chemoradiation therapy. Using a four-arm DaVinci system, we carry out the dissection in a medial to lateral fashion dividing the inferior mesenteric vessels and mobilizing the splenic flexure. A total mesorectal excision is performed to the level of the pelvic floor. The specimen is delivered through a wound protector covering the anus. The sigmoid colon is divided extracorporeally, an anvil is secured. Using robotic instruments, a purse-string is sutured to the rectal stump and tied around the EEA stapler spike. An end-to-end anastomosis is created under vision. A diverting ileostomy is performed. This novel robotic procedure eliminates the need for an incision for specimen extraction and may facilitate transection of the rectum during RLAR.