420 Laparoscopic Low Anterior Resection With Transrectal Specimen Extraction and Intracorporeal Anastomosis

2010 ◽  
Vol 138 (5) ◽  
pp. S-850
Author(s):  
Philip A. Omotosho ◽  
Jin S. Yoo ◽  
Aurora D. Pryor
2021 ◽  
Vol 105 (1-3) ◽  
pp. 21-25
Author(s):  
Takuya Shiraishi ◽  
Naoki Tomizawa ◽  
Tatsumasa Andoh ◽  
Takuhisa Okada ◽  
Naoya Ozawa

There are some reports of totally laparoscopic surgery performed by intracorporeal anastomosis without abdominal incision. However, intracorporeal anastomosis with prolapsing technique is difficult and complicated via laparoscopic surgery alone. We found it easier to achieve totally laparoscopic low anterior resection (LAR) by anastomosis anally. Our procedure was performed in 32 patients. After the prolapsed rectum with the tumor was transected, reconstruction was performed by using a double-stapling technique (DST) or a hand-sewn technique (HST). In the DST, the proximal colon was pulled outside transanally, and the anvil head was inserted into the colon and returned to the abdominal cavity. The anal-side rectum was closed using a linear stapling device, and DST was performed. The HST was modified from intersphincteric resection anastomosis. No patient experienced complications associated with this procedure. Cosmetic satisfaction was achieved. All patients obtained disease-free margins pathologically, and none experienced local recurrence. Intracorporeal anastomosis of totally laparoscopic low anterior resection is difficult via laparoscopic ports only. It can be simplified by operating with anastomosis via the anus.


2021 ◽  
Author(s):  
Ahao Wu ◽  
Bowen Wu ◽  
Xufeng Shu ◽  
Yi Cao ◽  
Qingwen Zeng ◽  
...  

Abstract Objective: To evaluate the feasibility and safety of temporary ileostomy via median specimen extraction site in the lower abdomen. Methods: Twenty-two patients who underwent laparoscopic radical resection for rectal cancer and needed temporary ileostomy were prospectively enrolled. Temporary ileostomy was placed on the median specimen extraction site of the lower abdomen. Intraoperative and postoperative conditions, stoma-related complications and ileostomy reversal surgery were observed. d. Results: Among the 22 patients, there were 14 female patients and 8 male patients: the average age was 56 ±14 years; the average body mass index was 22.0 ±3.4 kg/m2; the average tumour size was 4.4 ±2.2 cm; the average distance between the tumour and the dentate line was 5.9 ±2.3 cm; the average time of laparoscopic low anterior resection was 221 ±56 minutes; the average blood loss was 168 ±91 ml; and the average postoperative hospital stay was 9.9 ±3.9 days. The average ileostomy reversal surgery time was 72 ±15 minutes, the average blood loss was 50 ±27 ml, and the average postoperative hospital stay was 5.9 ±1.0 days. Stoma-related complications occurred in 5 patients, of which one was treated by emergency surgery. Conclusion: In laparoscopic low anterior resection, patients with temporary ileostomy via the median specimen extraction site did not have serious complications that required surgical intervention during hospitalization, and there was no mortality during the perioperative period. It is safe and feasible to perform temporary ileostomies via the median specimen extraction site in the lower abdomen, but for permanent ileostomies, the median site in the lower abdomen should be carefully selected as the ileostomy site.


2021 ◽  
pp. 000313482110111
Author(s):  
Erol Piskin ◽  
Muhammet Kadri Çolakoğlu ◽  
Ali Bal ◽  
Volkan Oter ◽  
Erdal Birol Bostanci

Background Minimally invasive surgery is a rising trend in colorectal surgery and is on its way to becoming the gold standard due to the benefits it provides for patients. This study aims to test the efficacy for educational purposes by evaluating the videos published on YouTube ( www.youtube.com ) channel for low anterior resection procedure in rectum surgery. Methods We searched YouTube on October 17, 2020 to choose video clips that included relevant information about laparoscopic low anterior resection (LAR) for rectal cancer. Results We included 25 academics and 75 individual videos in this study. The teaching quality of the videos was evaluated according to academic and individual videos, and it was seen that the teaching quality scores of academic videos were higher and this result was statistically significant ( P = .03). The modified Laparoscopic Surgery Video Educational Guidelines (LAP-VEGaS) criteria were found that the score was higher in individual videos ( P = .014). The median Video Power Index (VPI) value was 1.50 (range .05-347) and the mean ratio was 7.01 ± 3.52. There was no statistically significant difference between the 2 groups ( P = .443). Discussion Video-based surgical learning is an effective method for surgical education. Our study showed that the video quality and educational content of most of the videos about the low anterior resection procedure on YouTube were low. The videos of academic origin seem more valuable than individual videos. As far as video popularity is concerned, YouTube viewers are not selective. For this reason, training videos to be used for educational purposes must be passed through a standardized evaluation filter.


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