Robotic Right Colectomy with Complete Mesocolic Excision (CME): The Suprapubic Bottom-to-up Approach with Gut Transection Guided by Fluorescence Angiography and Intracorporeal Ileocolic Anastomosis - a Video Vignette.
[Robotic Right Colectomy with Complete Mesocolic Excision (CME): The Suprapubic Bottom-to-up Approach with Gut Transection Guided by Fluorescence Angiography and Intracorporeal Ileocolic Anastomosis - a Video Vignette]. Zentralbl Chir. 2019 Dec 02;: Authors: Schulte Am Esch J, Sarikaya H, Jünemann LM, Starke M, Kolokotronis T, Müller JS, Krüger M, Benhidjeb T PMID: 31791093 [PubMed - as supplied by publisher]
ConclusionsThree arteries emerging from the superior mesenteric artery exist: the ICA, the RCA and the MCA. The ICA and the MCA are the most constant. Knowledge of this vascular anatomy is essential for performing right-sided colectomies.
CONCLUSION: This study shows that 1.2% of patients would have been incorrectly diagnosed as Stage II if extended D3 mesenterectomy had not been performed. Similarly, lymph node metastases would have been left behind in 4.1% of patients if extended D3 mesenterectomy had not been performed. PMID: 31237343 [PubMed - as supplied by publisher]
Abstract Diverticular bleeding is a complication of diverticular disease but in contrast to diverticulitis, publications concerning diverticular bleeding are less common. Diverticular bleeding is the cause of approximately 20-50% of cases of lower gastrointestinal bleeding and in rare cases can be life-threatening. The main symptom of diverticular hemorrhage is painless hematochezia and the German guidelines recommend that further diagnostics of suspected diverticular bleeding should be performed in hospital. Interdisciplinary diagnostic and therapeutic algorithms recommend primary endoscopy in acute as well ...
ConclusionThis study showed acceptable dimensional inter-arterial correlations between 3D printed models, 3D virtual models and authentic soft tissue anatomy of the central mesenteric vessels, and weaker inter-venous correlations between all the models, reflecting the highly variable nature of veins in situ.
ConclusionsThis is the first collaborative report showing safety and feasibility of taIPAA. Despite technical variations, outcomes are similar across centers. A large multi-institutional, international IPAA collaborative is needed to compare technical factors and outcomes.
AbstractRecently, Indocyanine Green (ICG)-enhanced fluorescence has been introduced in laparoscopic colorectal surgery to provide detailed anatomical informations. The aim of our study is the application of ICG imaging during laparoscopic colorectal resections: to assess anastomotic perfusion to reduce the risk of anastomotic leak, to facilitate vascular dissection when vascular anatomy of tumor site is unclear, and to identify ureter to prevent iatrogenic injury. After the transection, 5 ml of ICG solution is intravenously injected. A Full HD IMAGE1S camera, switching to NIR mode, in few seconds provides a real-time...
A 77 year old man presented with acute mesenteric ischaemia and peritonitis. Computed tomography angiography revealed acute thrombosis of the proximal calcified superior mesenteric artery (SMA) arising from a coralliform aorta (A, asterisk). He underwent emergency retrograde open mesenteric stenting (ROMS) using a 7 × 59 mm Atrium Advanta V12 stent graft (Maquet, Rastatt, Germany) with great saphenous vein patch angioplasty (panel B), followed by right colectomy. Ilio-mesenteric bypass was not feasible because of previous iliac kissing stents and femoro-femoral bypass.
Clinics in Colon and Rectal Surgery 2018; 31: 243-250 DOI: 10.1055/s-0037-1607963Diverticular bleeding is the most common cause of lower gastrointestinal bleeding with nearly 200,000 admissions in the United States annually. Less than 5% of patients with diverticulosis present with diverticular bleeding and present usually as painless, intermittent, and large volume of lower gastrointestinal bleeding. Management algorithm for patients presenting with diverticular bleeding includes resuscitation followed by diagnostic evaluation. Colonoscopy is the recommended first-line investigation and helps in identifying the stigmata o...
ConclusionThis paper therefore documents the worth-knowing behavior causing considerable confusion for the operating surgeon unaware of the abnormality and shows its concrete impact on patient-tailored surgical practice, in particular for laparoscopic D3 colectomy (including the “uncinated process first” approach).