Ulteriori informazioni
The Operation Primer "Laparoscopic Sigmoidectomy for Cancer" refers especially to future surgeons, who wish to familiarize with minimal invasive colorectal surgery procedures. Besides, it is useful for experienced surgeons in open colorectal surgery who want to apply the minimally invasive technique.
Sommario
Structure and handling of the Operation Primer.- I Preparations for the operation.- Instruments.- Emptying the bladder.- Positioning of the patient.- Shaving.- Neutral electrode.- Setting the equipment.- Skin disinfection.- Sterile draping.- Positioning of the operating team.- II Creating the pneumoperitoneum - placing the optical trocar.- a) Hasson Method (open technique), b) Trocar with obtical obturator, c) Veress needle (closed technique).- III Placing the working trocars.- Placing the working trocars.- IV Nodal points.- 1. Exploring the abdominal cavity.- 2. Identifying the anatomical landmarks.- 3. Mobilizing the left lateral colon.- 4. Mobilizing the splenic flexure.- 5. Dissecting the lymph nodes and the sigmoid mesentery.- 6. Dividing the inferior mesenteric vessels.- 7. Dissecting the upper mesorectum.- 8. Dividing the upper rectum.- 9. Extracting the sigmoid .- 10. Dividing the proximal colon and preparing the anastomosis extraabdominally.- 11. Preparing the anastomosis intraabdominally.- 12. Anastomosing the colon.- 13. Verifying the anastomosis.- 14. Finishing the operation.- V Management of difficult situations, complications and mistakes.- 1. Adhesions. 2. Blood vessel injuries - a) Diffuse bleeding / bleeding from minor vessels, b) Bleeding from major vessels.- 3. Organ injuries - a) Greater omentum, b) Bowel, c) Spleen, d) Stomach, e) Liver and pancreas.- 4. Preperitoneal air emphysema - a) Veress needle, b) Trocar.- 5. Losing a swab in the abdominal cavity.- 6. Difficulties when identifying the inferior mesenteric artery.- 7. Adhesion of the sigmoid to the abdominal wall.- 8. Injury of the left sympathic trunk.- 9. Injury of the left ureter.- 10. Injury of the iliac vessels.- 11. Difficulties when clipping.- a) Incorrectly positioned clips, b)Unsafely positioned clips, c) Lost and slipped clips.- 12. Positive anastomotic leak test.- 13. Rotation of the left colon.- 14. Spastic colon.- 15. Spread of tumour cells.- VI Anatomical variations.-Vascular variations.- Sigmoid position variations.- Appendix.- Sample operation note.- Bibliography.- List of key words.
Riassunto
The Operation Primer "Laparoscopic Sigmoidectomy for Cancer" refers especially to future surgeons, who wish to familiarize with minimal invasive colorectal surgery procedures. Besides, it is useful for experienced surgeons in open colorectal surgery who want to apply the minimally invasive technique.
