Download Free Medical Laparoscopic colorectal surgery PowerPoint Presentation

Laparoscopic colorectal surgery PowerPoint Presentation

DOWNLOAD MEDICAL POWERPOINT PRESENTATION

About This Presentation

Description : Check out this medical presentation on Colon and Rectal Surgery, which is titled "Laparoscopic colorectal surgery", to know about laparoscopic colorectal surgery.

Tags : Colon, Rectal Surgery, Laparoscopic colorectal surgery

Published on : Jul 20, 2021 | Views : 2058 | Downloads : 5

Shareable Url :

Embed Code :

Comment

Transcript

Slide 1-

Laparoscopic colorectal surgery M. Iqbal Rivai, MD DIGESTIVE SURGEON Digestive division, Department of Surgery Faculty of Medicine Andalas University General Hospital of Dr. M. Djamil Padang, Indonesia
Slide 2-

Indonesia Incidence of colorectal cancer in indonesia is 12.8 for 100.000 adult population with mortality of 9.5% of all cases of cancer. The third most common cancer in Indonesia (1,8/100.000)( Ministery of Health, 2006) and the second most common death was caused by cancer Colorectal Malignancy The third most common cancer in worldwide with over 1,4 million new cases in 2012
Slide 3-

In principle, the same operation is being performed in open or laparoscopic abdominal surgery All operations are performed under general anaesthesia
Slide 4-

Laparoscopy: Colorectal Cancer Levels of evidence* *Can Med Assoc, 1979
Slide 5-

Operations performed laparoscopically
Slide 6-

Can all bowel operations be performed laparoscopically It will be the decision of digestive surgeon as to whether the operation may be performed laparoscopically
Slide 7-

Advantages Smaller wounds Less pain Faster recovery Disadvantages Port site recurrence Oncological margins Cost Longer operation Learning curve
Slide 8-

Benefits for surgeon
Slide 9-

Bowel Function Recovery The evidence that laparoscopy offers faster bowel function recovery than the traditional open approach may be considered high
Slide 10-

Laparoscopy: Quality of life 225 patients 117 Laparoscopy , 108 Open Pain, hospital stay Quality of life (2 days, 2 weeks, 2 months) Symptom distress scale Quality of life index Global rating scale (1-100)
Slide 11-

Results M.Djamil Hospital and Siti RahmahIslamic Hospital January 2015 – Desember 2016
Slide 12-

Results
Slide 13-

ppt slide no 13 content not found
Slide 14-

Laparoscopy: Colorectal Cancer The superiority of laparoscopy in reducing pain during the same length of the postoperative period seems evident (Level I) Other aspects of quality of life warrant further investigation
Slide 15-

Laparoscopy: Colorectal CancerHospital stay There is high evidence (Level I) that  laparoscopy for malignancy is associated with an earlier discharge compared to laparotomy
Slide 16-

Laparoscopy: Colorectal CancerRecurrence
Slide 17-

Laparoscopy: Colorectal Cancer Survival
Slide 18-

Laparoscopic Colectomy Significantly longer operative times Possibly more expensive Possibly worse short term immune effects
Slide 19-

Laparoscopic Colectomy “Laparoscopic resection of colorectal malignancy was more expensive and time-consuming” “ The new procedure’s advantages revolve around early recovery from surgery and reduced pain”
Slide 20-

Laparoscopic Colectomy : Advantages vs Open Colectomy Improved cosmesis (no data but appears uncontentious) Quicker hospital discharge Less narcotic use, though possibly larger benefits for certain types of colectomy (low colonic) Possibly less pain at rest, at least for patients who have uncovered procedures Possibly earlier return of bowel function and resumption of normal diet
Slide 21-

Aplication of Minimally Invasive Surgery Short term benefits : Bowel function recovery Quality of life (including pain) Hospital stay Long term benefits : Recurrence Survival
Slide 22-

ppt slide no 22 content not found
Slide 23-

procedure
Slide 24-

Visualization of right colon  reflecting tAke omentum over the transverse colon
Slide 25-

Isolation of ileocolic pedicle Lifts the mesentry at the ileocecal junction IDENTIFYING THE DISTAL ILEOCOLIC PEDICLE WHICH IS HANDED TO THE ASISSTANT AND RETRACTED ANTERIORLY, INFERIORLY, AND LATERALLY
Slide 26-

The peritoneum is opened lateral to pedicle as well and ileocolic isolated completely near its base Open the peritoneum posterior to the ileocolic & parallel to the superior mesentric vessels
Slide 27-

Mobilization of the ascending colon & hepatic flexure Divided ileocolic pedicle is grasped and retracted anteriorly Preserving retroperitoneal fascia overlying the kidney & ureter Mesocolon is dissected Continus up behind the hepatic flexure and down behind the cecum
Slide 28-

Retracting the colon inferiorly  the hepaticocolic ligament is divided Medial to lateral approach along the line of toldt straightforward Heading inferiorly along the ascending colon white line of Toldt  the fusion of colic mesentery with the posterior peritoneum
Slide 29-

mobilization of small bowel mesentery from the retroperitoneum Cecum is retracted cephalad and anteriorly The remaining small bowel mesenteric attachment and any lateral attachment of colon are divided Ureter  identified  coursing over the iliac vessels at the pelvic inlet Right colon should be fully mobilized from retroperitoneum and can be moved into the left abdomen  expose the complete retroperitoneum and c-loop duodenum
Slide 30-

Division of right branch of the middle colic Right branch is isolated  divided  facilitates this transection Transection of the right branch of the middle colic  colon is now completely mobilized and entire retroperitoneum is seen with duodenum fully exposed
Slide 31-

Left hemicolectomy
Slide 32-

THANK YOU