Laparoscopic Deloyers procedure for tension-free anastomosis after extended left colectomy: technique and results

2016 ◽  
Vol 20 (12) ◽  
pp. 865-869 ◽  
Author(s):  
A. Sciuto ◽  
C. Grifasi ◽  
F. Pirozzi ◽  
P. Leon ◽  
R. E. M. Pirozzi ◽  
...  
Keyword(s):  
Left Colectomy ◽  
Tension Free ◽  
Deloyers Procedure

scholarly journals Single-port laparoscopic Deloyers procedure for tension-free anastomosis after extended left colectomy or subtotal colectomy

Medicine ◽  
2020 ◽  
Vol 99 (31) ◽  
pp. e21421
Author(s):  
Byung Jo Choi ◽  
Woojin Kwon ◽  
So Hye Baek ◽  
Won Jun Jeong ◽  
Sang Chul Lee
Keyword(s):  
Subtotal Colectomy ◽  
Single Port ◽  
Left Colectomy ◽  
Tension Free ◽  
Deloyers Procedure

scholarly journals Extended Left Colectomy with Coloanal Anastomosis by Indocyanine Green-guided Deloyers Procedure: A Case Report

2021 ◽  
Vol 5 (2) ◽  
pp. 202-206
Author(s):  
Kazuaki Okamoto ◽  
Shigenobu Emoto ◽  
Kazuhito Sasaki ◽  
Hiroaki Nozawa ◽  
Kazushige Kawai ◽  
...  
Keyword(s):  
Case Report ◽  
Indocyanine Green ◽  
Coloanal Anastomosis ◽  
Left Colectomy ◽  
Deloyers Procedure

scholarly journals Long splenic flexure carcinoma requiring laparoscopic extended left hemicolectomy with CME and transverse-rectal anastomosis: technique for a modified partial Deloyers in 5 steps to achieve enough reach and preserving middle colic vessels

2021 ◽  
Author(s):  
Salomone Di Saverio ◽  
Kostantinos Stasinos ◽  
Weronyka Stupalkowska ◽  
Umberto Bracale ◽  
Pierpaolo Sileri ◽  
...  
Keyword(s):  
Splenic Flexure ◽  
Primary Anastomosis ◽  
Colorectal Anastomosis ◽  
Ascending Colon ◽  
Right Colon ◽  
Left Hemicolectomy ◽  
Tension Free ◽  
Descending Colon ◽  
Deloyers Procedure ◽  
The Right

Abstract Introduction This How-I-Do-It article presents a modified Deloyers procedure by mean of the case of a 67-year-old female with adenocarcinoma extending for a long segment and involving the splenic flexure and proximal descending colon who underwent a laparoscopic left extended hemicolectomy (LELC) with derotation of the right colon and primary colorectal anastomosis. Background While laparoscopic extended right colectomy is a well-established procedure, LELC is rarely used (mainly for distal transverse or proximal descending colon carcinomas extending to the area of the splenic flexure). LELC presents several technical challenges which are demonstrated in this How-I-Do-It article. Technique and methods Firstly, the steps needed to mobilize the left colon and procure a safe approach to the splenic flexure are described, especially when a tumor is closely related to it. This is achieved by mobilization and resection of the descending colon, while maintaining a complete mesocolic excision to the level of the duodenojejunal ligament for the inferior mesenteric vein and flush to the aorta for the inferior mesenteric artery. Subsequently, we depict the adjuvant steps required to enable a primary anastomosis by trying to mobilize the transverse colon and release as much of the mesocolic attachments at the splenic flexure area. Finally, we present the rare instance when a laparoscopic derotation of the ascending colon is required to provide a tension-free anastomosis. The resection is completed by delivery of the fully derotated ascending colon and hepatic flexure through a suprapubic mini-Pfannenstiel incision. The primary colorectal anastomosis is subsequently fashioned in a tension-free way and provides for a quick postoperative recovery of the patient. Results This modified Deloyers procedure preserves the middle colic since the fully mobilized mesocolon allows for a tension-free anastomosis while maintaining better blood supply to the mobilized stump. Also, by eliminating the need for a mesenteric window and the transposition of the caecum, we allow the small bowel to rest over the anastomosis and the mobilized transverse colon and reduce the possibility of an internal herniation of the small bowel into the mesentery. Conclusions Laparoscopic derotation of the right colon and a partial, modified Deloyers procedure preserving the middle colic vessels are feasible techniques in experienced hands to provide primary anastomosis after LELC with improved functional outcome. Nevertheless, it is important to consider anatomical aspects of the left hemicolectomy along with oncological considerations, to provide both a safe oncological resection along with good postoperative bowel function.

Outcome of tension free open mesh repair of inguinal hernia

2020 ◽  
Vol 22 (1) ◽  
pp. 21-24
Author(s):  
Mohammad Masum ◽  
Md Aminul Islam ◽  
Masflque Ahmed Bhuiyan ◽  
Kazi Mazharul Lslam ◽  
Md Selim Morshed ◽  
...  
Keyword(s):  
Inguinal Hernia ◽  
Hernia Repair ◽  
Inguinal Hernia Repair ◽  
Mesh Repair ◽  
Groin Hernia ◽  
Synthetic Mesh ◽  
Indirect Inguinal Hernia ◽  
Prolene Mesh ◽  
Tension Free ◽  
Open Mesh Repair

Background: In the practice of General Surgery, hernia repair is the second most common procedure after appendectomy. Several methods have been developed over the years to try to improve hernia repair. Good result can be expected using Bassini's, McVay's, Shouldice's techniques provided the exact nature of hernia is recognized and the repair is done without tension using healthy tissue. The introduction of synthetic mesh started a new era in hernia surgery. The use of synthetic mesh repair of primary and recurrent hernias has gradually gained acceptance among surgeons. Objective: To find out the outcome and complications of open inguinal hernia repair with prolene mesh. Methods: This is a prospective cross sectional study conducted at Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, from December, 2011 to May, 2012. One hundred patients of inguinal hernia admitted in different surgical units of BSMMU, Dhaka for elective surgery were studied. We have given 1 gm ijv Cephradine per operatively and then 500 gm cephradine ijv 6 hourly for 24 hours followed by oral form of Cephradine for next 5 days. Polypropylene mesh of 11 cm x 7 cm size was used in all cases. All the operations were done by open tension free prolene mesh repair technique. Patients were followed for one year to see the outcome. Results: Out of 100 cases of inguinal hernia, 71 patients (71%) had indirect inguinal hernia and 29 cases (29%) had direct inguinal hernia; 90 cases (90%) were primary hernia and only 10 cases (10%) were recurrent hernia; 58 cases were right sided, 34 cases (34%) were left sided and 8 cases (8%) were bilateral. Complications of mesh repair of groin hernia in this study included wound infection (5%), scrotal oedema (2%), mesh infection (0%), scrotal hematoma (2%), echymoces of peri-incisional skin (5%), early wound and groin pain (7%), chronic inguinodynia (2%), hernia recurrence (1%). Conclusion: In the present study an attempt is made to evaluate the outcome of patients undergoing inguinal hernia repair by prolene mesh. The results confirm that Lichtenstein tension free mesh repair of inguinal hernia is safe and reliable for both primary and recurrent groin hernia, with less recurrence rate. Patient's compliance was good with minimum morbidity. Journal of Surgical Sciences (2018) Vol. 22 (1): 21-24

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