Laparoscopic Colorectal Surgery: A Step by Step Guide with Video Atlas

 

Description:

This comprehensive book provides the reader a perspective of the current evidence-based management of Laparoscopic Colorectal Surgery. It covers sections on benign surgery for IBD, diverticulitis, rectal prolapse etc. along with the procedures for colon and rectal cancers, including laparoscopic TME. The accompanying videos complement the text imparting specific operative skills of exposure, retraction, countertraction, dissection, vascular control, hemostasis, laparoscopic Stapling, anastomosis, specimen extraction and stoma formation. This book aims to help surgeons to learn, standardize, practice and master the complex skills of Laparoscopic colorectal surgery. Key Features Provides step by step solution to the difficulties encountered by the beginners by covering a section on bugbears. Caters to General, GI, Oncology and Colorectal surgeons who have the adequate basic laparoscopic skills and have already been doing some advanced laparoscopic surgery in form of laparoscopic Upper GI and bowel surgery and would want to start laparoscopic colorectal surgery. Covers a section on Robotic and single incision laparoscopic surgery providing the contemporary knowledge in this emerging field, whereas a section on trans-anal surgery provides a futuristic dimension to this field.

 

Table of Contents:

 

Video Atlas of Laparoscopic Colorectal Surgery

Foreword

Preface

Acknowledgments

Editor

Contributors

Section I: Introduction and Basic Concepts

1. History, Evolution, and Current Scenario of Laparoscopic Colorectal Surgery

Learning objectives

Introduction

Evolution of laparoscopic surgery

Technological evolution

Evolution of laparoscopic surgery in general

Technical evolution of rectal cancer surgery

Evolution of laparoscopy for colorectal cancers

Evolution of laparoscopic surgery for benign colorectal condition

Rectal prolapse

Inflammatory bowel disease

Diverticular disease

Laparoscopic colorectal surgery in emergency situations

Future of laparoscopic colorectal surgery

Summary

Key points

References

2. Training for Laparoscopic Colorectal Surgery

Learning objectives

Introduction

Laparoscopic surgery in colorectal diseases

Knowledge of basic laparoscopic surgical skills

Learning tools, techniques and methodologies

Animal and human cadaver training models

Endotrainer box

Virtual reality simulators

Training in a specialized colorectal unit

Standard training models for teaching advanced laparoscopic skills in colorectal surgery

General surgery apprenticeship and traineeship programmes

Fellowships in MAS or advanced laparoscopy

Master class or dedicated fellowship courses

Preceptorship and proctorship

Highly structured training courses

LAPCO programme

Training of a laparoscopic colorectal surgeon

Summary

Key points

References

3. Clinical Anatomy Related to Laparoscopic Colorectal Surgery

Learning objectives

Introduction

Embryological development of the colon and rectum

Vascular anatomy of colon and rectum

Arterial supply

Venous drainage

Lymphatic drainage of the colon and rectum

Fascias of colon and rectum

Posterior relationships of colon

Summary

Key points

References

4. Basic Principles and Techniques of Laparoscopic Colorectal Surgery

Learning objectives

Introduction

Potential benefits of laparoscopic colorectal surgery

Training in laparoscopic colorectal surgery

Basic principles of laparoscopic colorectal surgery

Patient preparation

OR setup

Standard port placements

Initial entry and initial assessment

Instrumentation

Energy sources

Staplers and accessories

Standard operative steps

Laparoscopic ileocaecal resection or right hemicolectomy for ileocaecal tuberculosis

Laparoscopic suture rectopexy for rectal prolapse

Laparoscopic sigmoid colectomy for sigmoid colon cancer

Laparoscopic APR for ultra-low rectal cancers

Laparoscopic anterior resection and low anterior resection for rectal cancers

Laparoscopic left hemicolectomy for descending colon cancer

Laparoscopic right hemicolectomy for right colon cancer

Laparoscopic transverse colectomy

Laparoscopic restorative proctocolectomy and ileal pouch anal anastomosis

Laparoscopic total colectomy and ileorectal anastomosis

Laparoscopic total proctocolectomy and ileostomy

Laparoscopic reversal of Hartmann’s operation

Laparoscopic colon replacement for corrosive strictures

Newer techniques and adjuncts

Intersphincteric dissection and coloanal anastomosis

Transvaginal/transanal specimen removal

Proximal diversion

Neoadjuvant chemoradiation

Adjuvant chemotherapy

Conversion in laparoscopic colorectal surgery

Complications of laparoscopic colorectal surgery

Summary

Key points

Videos

References

5. Patient Selection

Learning objectives

Introduction

Why selection of patient is essential?

Summary

Key points

References

6. Stoma and Its Complications

Learning objectives

Introduction

Stoma marking, counseling, and consenting

Indications for temporary stoma

Ileostomy versus colostomy

Preoperative oral antibiotics and mechanical bowel preparation

Anastomotic leak

Role of rectal drains to prevent stoma

Stoma care

Stoma complications

Mucocutaneous separation

Retraction/flush stoma

Bowel obstruction

Stenosis

Prolapse

Parastomal hernia

Granulomas

Pancaking

High-output ileostomy

Peristomal skin excoriations and infections

Stoma closure and its complications

Summary

Key points

Video

References

Section II: Perioperative Care of Patient

7. Bowel Preparation in Colorectal Surgery

Learning objectives

Introduction

The evidence

History of bowel preparation in colorectal surgery

Guidelines

Types of bowel preparation

Mechanical bowel preparation

Mechanical bowel preparation and oral antibiotic prophylaxis

Oral antibiotics alone

MOABP with IV antibiotics

Phosphate enemas

Contraindications for bowel preparation

Summary

Key points

References

8. ERAS in Colorectal Surgery

Learning objectives

Introduction

Components of ERAS protocols and current recommendations

Summary

Key points

References

9. Anesthetic Management of Laproscopic Colorectal Surgery

Learning objectives

Introduction

Preoperative assessment and optimization

Preoperative preparation

Physiological changes occurring during laparoscopic surgery

Effect on respiratory system

Effect on cardiovascular system

Renal and metabolic effect

Gastrointestinal effect

Anesthetic techniques and intraoperative monitoring

Goal-directed fluid therapy

Blood transfusion

Recovery

Pain control

Morbidity and mortality

Summary

Key points

References

10. Complications in Laparoscopic Colorectal Surgery

Learning objectives

Introduction and incidence

Classification of complications

Small bowel and duodenal injury

Splenic injury

Pancreatic and gastric injury

Major vessel injury

Surgical site infection

Wound disruptions

Early postoperative small bowel obstruction and postoperative ileus

Presacral bleeding

Ureteral injury

Bladder injury

Urethral injury

Urinary dysfunction

Sexual dysfunction

Female infertility

Minor bleeding

Major bleeding

Anastomotic dehiscence and leaks

Chronic presacral sinus

Strictures

Fistulas

Summary

Key points

Video

References

Section III: Laparoscopy in Benign Colorectal Diseases

11. Laparoscopic Ileocecal Resection

Learning objectives

Introduction

Applied anatomy and physiology of the ileocecal area

Indications

Contraindications

Difference in resection between benign and malignant indications

Preoperative preparation

Results and consequences of resection

Summary

Key points

Video

12. Laparoscopic Appendectomy

Learning objectives

Introduction

Indications

Absolute contraindications

Relative contraindications

Selection of patients

Preoperative preparation

OR setup

Operative steps

Postoperative course and recovery

Postoperative complications

SILS appendicectomy

Advantages of laparoscopic surgery

Disadvantages of laparoscopic surgery

Summary

Key points

Video

References

13. Laparoscopic Sigmoid Colectomy for Diverticulitis

Learning objectives

Introduction

Acute diverticulitis

Diagnosis of acute diverticulitis

Management of acute complicated diverticulitis

Choice of procedure

Laparoscopic versus open approach

Advantages of laparoscopy in an acute setting

Disadvantages of laparoscopy in an acute setting

Prerequisites for laparoscopy in an acute setting

Technical challenges in laparoscopy in the acute setting

Laparoscopic lavage in acute diverticulitis

Literature review

Patient positioning

Port placement

Operative steps

Complications

Conversion to laparoscopic colectomy

Laparoscopic sigmoid colectomy in acute diverticulitis

Operative steps

Complications

Summary

Key points

Video

References

14. Laparoscopic Rectopexy for Rectal Prolapse

Learning objectives

Introduction

Historical perspective

Types of rectal prolapse

Oxford rectal prolapse grading system (ORPG)

Indications for surgery

Goals of surgery

Surgical options

Selection of approach and controversies

Preoperative evaluation

Preoperative preparation

Operative principles for posterior suture/mesh/resection rectopexy

OR setup

Port placements

Operative steps of laparoscopic suture/resection rectopexy

Operative techniques

Postoperative care and early outcomes

Postoperative complications

Long-term functional results

Robotic rectopexy

Summary

Key points

Videos

References

15. Laparoscopic-Assisted Stomas and Stoma Reversal

Learning objectives

Laparoscopic stoma formation

Loop ileostomy

Loop stoma reversal

Colostomy

Sigmoid colostomy

Transverse colostomy

Sigmoid stoma reversal (Hartmann’s reversal)

Operative approach

SILS stoma

Complications

Summary

Key points

Videos

References

16. Laparoscopic Restorative Proctocolectomy and Ileal Pouch Anal Anastomosis

Learning objectives

Introduction

Goals of surgery

Surgical options

Selection of patients

Indications for RPC-IPAA

Contraindications for RPC-IPAA

Advantages of RPC-IPAA

Disadvantages of RPC-IPAA

Operative principles of laparoscopic assisted RPC-IPAA

Preoperative preparation

Operative steps

OR setup

Port placement philosophy

Operative technique

Postoperative care and usual recovery

Postoperative complications – early and late

Pouchitis

Pouch failure

Stricture

Fecal incontinence

Pouch dysplasia/cancer

Sexual dysfunction

Female infertility

Anal transition zone inflammation

Anal transitional zone dysplasia

Functional results of RPC-IPAA

Controversies

Authors’ experience

Summary

Key points

Videos

References

17. Parastomal Hernias

Learning objectives

Introduction

Incidence of PH

History of laparoscopy in stomal surgery

Classification of PH

Risk factors

Diagnosis of PH

Indications and contraindications for surgery

Surgery for PH

Prevention of parastomal hernia

Transrectus or pararectus

Size of the trephine

Extraperitoneal approach

Role of prophylactic mesh

Techniques of repair

Onlay mesh repair

Intraperitoneal mesh repair

Laparoscopic versus open repair

Recurrence

Recurrent PH repair

Robotic PH repair

Summary

Key points

Videos

References

Section IV: Laparoscopy Colorectal Cancer Surgery

18. Laparoscopic versus Open Colorectal Resection: An Evidence-Based Review

Learning objectives

Introduction

Historical perspectives of laparoscopic colorectal surgery

Filling the gap between open and laparoscopic surgery

Laparoscopic-assisted techniques

Hand-assisted techniques

Evidence for quality of life after laparoscopic colorectal cancer resection

Rectal cancer

Efficacy of minimal invasive surgery for rectal malignancy

Locally advanced rectal disease

Indications for extended lymphadenectomy in rectal cancer

Future of laparoscopic colorectal surgery

Summary

Key points

References

19. Laparoscopic Right Hemicolectomy for Right Colon Cancer

Learning objectives

Introduction

Definition

Indications

Preoperative work up

Operative technique

Positioning and port placement

Operative steps

Postoperative care

Role of SILS (single incision laparoscopic surgery)

Summary

Key points

Videos

References

20. Laparoscopic Transverse Colectomy for Transverse Colon Cancer.

Learning objectives

Introduction

Anatomy

Evidence of laparoscopic resection

Preoperation preparation

Steps of laparoscopic transverse colectomy

Port placement

Greater omentum dissection

Ligation of the middle colic vein and artery

Mobilization of the mesocolon

Delivery of the colon

Summary

Key points

References

21. Laparoscopic Hemicolectomy for Left Colon Cancer

Learning objectives

Introduction

Vascular anatomy of the left colon

Lymphatic drainage of the left colon

Complete mesocolic excision (CME)

Resection templates for left colon cancer

Laparoscopic left hemicolectomy: Surgical technique

Surgical steps

Summary

Key points

Video

References

22. Laparoscopic Anterior Resection and Total Mesorectal Excision for Rectosigmoid Cancer

Learning objectives

Introduction

Preoperative patient preparation

Operating room: Patient position and draping with placement of equipment and team

Position of the patient

Position of the surgeon and equipment

Initiating the procedure: Port placement and laparoscopic instrumentation

Port placement

Instruments required

Performing the procedure

Medial to lateral dissection: Inferior mesenteric vein ligation

Medial to lateral dissection: Mesocolic dissection

Ligation of inferior mesenteric artery

Enter the lesser sac

Haray maneuver and posterior pelvic dissection

Lateral peritoneal dissection and mobilization of splenic flexure

Back to pelvic dissection (anterior and lateral dissection)

Distal rectal transection and anastomosis of the rectum

Extracorporeal procedure

Summary

Key points

Videos

References

23. Techniques for Laparoscopic Low Anterior Resection, Ultra Low Anterior Resection, and Inter Sphincteric Resection (ISR)

Learning objectives

Introduction

Indications

Contraindications

Laparoscopic total mesorectal excision

Preoperative preparation

Theater setup: Patient position

Ports position

Technique

Exploration of peritoneal cavity

Division of the inferior mesenteric pedicle (medial to lateral approach)

Medial to lateral mobilization of descending colon, splenic flexure, and transverse colon

Mobilization of lateral attachments of rectosigmoid and descending colon

Splenic flexure and transverse colon mobilization

Pelvic dissection

Posterior mobilization

Medial and lateral mobilization

Anterior mobilization

Distal occlusion

Rectal transection

Specimen removal

Anastomosis

Assessment of anastomosis

Intersphincteric resection

Diversion ileostomy

Postoperative care

Postoperative follow-up

Discussion

Summary

Key points

Videos

References

24. Laparoscopic Conventional Abdominoperineal (CAPE) and Extra-Levator Abdominoperineal Resection (ELAPE)

Learning objectives

Indications

Risk factors

Staging workup (with emphasis on how MRI helps in loco-regional staging and preoperative planning)

Function after low anterior resection, and low anterior resection syndrome (LARS)

Surgical considerations

LAR versus APR, sphincter preservation

Conventional APR versus ELAPE

ELAPE in supine versus prone position

Perineal closure in ELAPE

Pelvic floor reconstruction after ELAPE

Laparoscopic ELAPE

Preoperative preparation

Steps of the procedure: Tips and tricks

Options for perineal reconstruction

Sacrectomy

Maintaining intestinal continuity after APE

Quality of life (QOL) issues

Laparoscopic versus robotic rectal cancer surgery

Summary

Key points

Videos

References

25. Laparoscopic Subtotal/Total/Proctocolectomy

Learning objectives

Introduction

Definition

Indications

Synchronous colon cancer

Lynch syndrome

Obstructed left sided colon cancers

Familial adenomatous polyposis (FAP)

Ulcerative colitis

Crohn’s disease

Chronic severe constipation

Contraindications

Summary

Key points

References

26. Laparoscopic Management of T4 Tumor and Pelvic Exenteration for Locally Advanced Tumors

Learning objectives

Introduction

What is T4 colorectal cancers or LACRC?

Clinical presentation

Preoperative evaluation

Colonoscopy

Radiological imaging

Selection of patients for neoadjuvant chemoradiation

Role of laparoscopy and surgical technique for T4 colorectal cancers/LACRC

Key operative steps in routine laparoscopic colorectal surgery

Key differences in operative steps in T4 or LACRC

In male patients

Specimen retrieval and formation of ileal conduit and stapler anvil head insertion in male patients

In female patients

Special situations

Summary

Key points

Videos

References

27. Laparoscopic Surgery in Obstructed and Recurrent Tumors

Learning objectives

Introduction

Clinical presentation

Management

Treatment

Laparoscopic surgery in obstructed colorectal cancers

Laparoscopic surgery in recurrent colorectal cancers

Risk factors for recurrence

Classification of recurrences

Key steps for a safe surgery

Palliative resection

Postoperative care and follow-up

Summary

Key points

Video

References

28. Resection for Colorectal Liver Metastasis

Learning objectives

Introduction

Evaluation of resectability

Management of resectable liver metastasis

Timing of resection for synchronous liver metastases

Laparoscopic major (right/left) hepatic resection

Laparoscopic left lateral sectionectomy

Laparoscopic segmentectomies/Nonanatomical resections

Radiofrequency ablation

Management of unresectable liver metastasis

Outcomes of laparoscopic resection for CRLM

Management flowchart for colorectal liver metastases

Summary

Key points

References

29. Specimen Retrieval after Laparoscopic Colectomy and NOSE

Learning objectives

Introduction

Mini-laparotomy or convenient incision

Criteria for site selection

Transabdominal

BMI

Type of incisions for retrieval

Issues with mini-laparotomies

NOSE

Background

Selection factors for NOSE

Patient factors

BMI

Sex

Anatomic location

Specimen factors

Other potential factors

Summary

Key points

Video

References

Section V: Robotic Colorectal Surgery

30. Robotic Colonic Cancer Surgery

Learning objectives

Introduction

Equipment

General principles

Right hemicolectomy

Left and sigmoid colectomy

Transverse colectomy

Robotic colectomy in the era of complete mesocolic excision (CME)

Summary

Key points

References

31. Robotic Rectal Cancer Surgery

Learning objectives

Introduction

Preoperative preparation and precautions

Position, port placement, and instrumentation

Steps of surgery

Nerves

Margins

Vascularity

Robotics in rectal cancer

Conversion rate

Learning curve

Short-term clinical outcomes

Sexual and urinary functions

Oncological outcomes

Cost

Advantages of robot-assisted TME for rectal cancer

Summary

Key points

Videos

References

Section VI: Transanal Surgery

32. Transanal Minimally Invasive Surgery (TAMIS)

Learning objectives

Introduction

Indications

Reach of TAMIS

Risks of TAMIS

Contraindications

Evaluation of the lesion

Preparation of the lesion

Bowel preparation

Deep venous thrombosis prophylaxis

Prevention of urinary retention

Equipment and operative set-up

Equipment: Articulated stabilizing arm

Operative proctoscopes

Optics

Long instruments

Insufflator/suction/irrigation/light/electrocautery machines

Adaptable laparoscopic instruments

Harmonic scalpel

LigaSure

Resection options

Mucosectomy

Partial rectal wall excision

Full-thickness excision

Full-thickness excision with perirectal fat

Procedure

Complications

Peritoneal entry

Bleeding

Dehiscence

Conversion to laparotomy

Urinary

Anal incontinence

Recto-vaginal fistula

Summary

Key points

Video

References

33. Transanal Total Mesorectal Excision for Rectal Cancer

Learning objectives

Transanal TME history and results

Preoperative evaluation

Indications and contraindications

Preoperative assessment

Operative approach

Positioning

Abdominal dissection

Transanal dissection

‘Rendez-vous’

Anastomosis

Complications of taTME

Urethral injury

Carbon dioxide embolism

Anastomotic leaks

Summary

Key points

Videos

References

34. Combined Endoscopic-Laparoscopic Surgery (CELS) for Colorectal Polypectomy

Learning objectives

Introduction

CELS polypectomy surgical technique

Benefits and limitations of CELS polypectomy

Current research on CELS polypectomy

Summary

Key points

References

Section VII: Hand-Assisted AND Single-Incision Laparoscopic Colorectal Surgery

35. Hand-Assisted Laparoscopic Colorectal Surgery

Learning objectives

Introduction

HAL colorectal resections

Indications

Preoperative preparation

Surgical instruments

Surgical steps

Position

Incision and trocar placement

Camera port

Working port

Surgical procedure

Modifications

Summary

Key points

Video

References

36. Single-Incision Laparoscopic Colorectal Surgery

Learning objectives

Introduction

SILS ports and equipment

Robotic SILS

Single-incision laparoscopic appendectomy

Surgical tips

Single-incision laparoscopic right hemicolectomy

Surgical tips

Single-incision laparoscopic left hemicolectomy

Surgical tips

Single-incision laparoscopic anterior resection

Single-incision laparoscopic total colectomy

Surgical tips

Summary

Key points

Videos

References

Index

 

An aparitie	27 Nov. 2020
Autor	Sanjiv Haribhakti
Dimensiuni	22.23 x 1.91 x 29.21 cm
Editura	CRC Press
Format	Hardcover
ISBN	9780367352844
Limba	Engleza
Nr pag	259