Laparoscopic Colorectal Cancer Surgery: Operative Procedures by Makio Mike
By Makio Mike
This exact consultant describes colorectal surgical procedure tactics utilizing scientific terminology and anatomical phrases originating from embryology.
within the final decade, laparoscopic approaches in gastrointestinal surgical procedure were superior and their safeguard has considerably more desirable. With the variety of situations of colorectal melanoma surgical procedure expanding and laparoscopic surgical procedure now not thought of a really good surgical procedure, the popularity of the right kind anatomy is essential in those strategies. regrettably, in spite of the fact that, the certainty of scientific anatomy is usually become independent from that of uncomplicated surgical innovations. before everything, the dissecting layer may be presumed to derive from the fascial anatomy in line with embryological popularity. in addition, the recommendations presently getting used by means of surgeons may be defined in enough aspect and the proper anatomical phrases must always be used. In view of this, this precious monograph advantages gastrointestinal surgeons and normal surgeons who're all for the therapy of colorectal cancer.
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Extra info for Laparoscopic Colorectal Cancer Surgery: Operative Procedures Based on the Embryological Anatomy of the Fascial Composition
A nerve bundle from the inferior mesenteric plexus on the right side of the IMA is divided with the USAD; the IMA is exposed except on the left side; the artery is dissected with dissecting forceps, clamped with three Hem-o-lok™ clips (Weck/Teleflex Medical, USA); and the artery is divided (Fig. 20). The assistant’s right hand forceps grasps the sigmoid mesocolon to hold the fusion fascia of Toldt like a screen. Ureter Opened sigmoid fossa There is a nerve arcade from the lumbar splanchnic nerve to the superior hypogastric plexus on the left side of the IMA.
This peritoneal cutting continues to the rectovesical pouch as far as possible Left Right Rectum Rectum Fascia propria of the rectum Deep subperitoneal fascia Deep subperitoneal fascia Left neuro-vascular corridor Right ureter Left ureter Neuro-vascular corridor Left ureter Left common iliac artery Right hypogastric nerve Left hypogastric nerve Fig. 18 Further dissection of the left lateral side of the rectum. After incision in the left peritoneum of the rectum, the dissection continues in the fossa between the ureter and rectum.
29 Dissecting layer of the sigmoid colon (Incorrect rationale). The surgeon feels there is a sheet of deviation occurring between the medial dissected plane and the lateral dissected plane. In this regard, there has been an explanation that the former is the dissection of the ventral side of the deep subperitoneal fascia and the latter is inside of the fusion fascia of Toldt. However, this is erroneous in light of the definition of the fusion fascia Lifting to the ventral and caudal side Lifting to the ventral and caudal side Left Right Rectum Superior rectal artery Fascia propria of the rectum ∗ Hypogastric nerve Hypogastric nerve Fig.