Hellow guys, Welcome to my website, and you are watching Laparoscopic complete mobilization of the sigmoid colon & the rectum in a male patient. and this vIdeo is uploaded by Cancer Surgery Masterclass at 2020-02-22T17:40:13-08:00. We are pramote this video only for entertainment and educational perpose only. So, I hop you like our website.
| Name | Laparoscopic complete mobilization of the sigmoid colon & the rectum in a male patient |
| Video Uploader | Video From Cancer Surgery Masterclass |
| Upload Date | This Video Uploaded At 23-02-2020 01:40:13 |
| Video Discription | Hello everyone, Welcome to another video presentation on laparoscopic colorectal surgery. Today we are going to show you our technique of complete laparoscopic sigmoid & rectal mobilization in a male patient. The peritoneum over the aorta is incised & the incision is continued cranially till the likely site of origin of the Inferior mesenteric artery (IMA) is reached. IMA is divided about 3 cm above its origin to avoid damaging the sympathetic plexus around it. IMV is found lateral to the IMA & is divided. The plane of dissection is just posterior to the divided vessels. You can see the Left ureter & the gonadal vessels below the plane of medial to lateral mesenteric dissection. The next step is to reach the posterior dissection plane of the mesorectum. It must be remembered not to dissect too close to the aortic bifurcation & the sacral promontory to avoid the superior hypogastric plexus. The posterior avascular plane is reached & the dissection is carried out caudally as far as possible. During this part of the dissection avoid using monopolar diathermy to minimize accidental damage to the pelvic veins & torrential bleeding. The sigmoid colon & the left colon are then relieved of the lateral pelvic attachments. This leads to complete mobilization of the lower left colon. Dividing the sigmoid colon with an endostapler makes the pelvic dissection easy but we do not routinely do that to minimize the cost of operation, since we have free health care. The peritoneal fold anterior to the rectovesical pouch is incised. Having articulating instruments will be really helpful during the pelvic dissection but unfortunately we are not privileged to afford them. Before proceeding in the anterior plane of dissection of the mesorectum it is wise to continue with the lateral dissection deep into the pelvis. There is no clear plane of lateral dissection therefore avoid dissecting too laterally to preserve the right & left hypogastric nerves & the inferior hypogastric plexus. Now we perform the anterior dissection & soon you will see the seminal vesicles. From this point there is a thin but consistent plane of dissection through the Denonvilliers' fascia right up to the base of the prostate. Finally the lowermost rectum can be mobilized by dividing the fascial attachments to the lateral & posterior pelvic wall thus revealing the pelvic floor. Now you can see the rectum being separated from the prostate. Once the dissection is over, you will see the muscular anorectal junction devoid of any fat. Following the perineal delivery of the specimen, you can see the glistening bilobed appearance of the mesorectum posterior to the rectum. This channel is dedicated to everyone who is interested in the field of Oncological surgery & is conducted by Dr. Anuruddha Thewarapperuma MBBS MS, a Consultant Cancer Surgeon from Sri Lanka. This includes a series of video classes & lectures on operative surgery with illustrations, valuable tips and advice. Please feel free to comment, give suggestions & ask questions in the comment section below. We hope this channel will be thought provoking and inspiring to all the surgeons, medical students, aspiring doctors, nurses and anyone in the surgical community who is interested in Cancer Surgery. We wish you all the best! Thank you! Contact us [email protected] |
| Category | Education |
| Tags | Cancer | Cancer surgery | Oncology | Oncological surgery | surgery lectures | video class | surgeons | doctors | nurses | Nucleus Medical Media | Medstar Health | Operation | Breast cancer | Thyroid cancer | Lung cancer | Esophageal cancer | Head & neck cancer | Gastric cancer | Colon cancer | Liver cancer | Pancreatic cancer | Uterine cancer | Ovarian cancer | Prostate cancer | Bowel cancer | Bone cancer | Skin cancer | John Gilmore M.D. | Dr. Najeeb Lectures | Laparoscopic surgery | rectal cancer |
