The Educational Quality of Laparoscopic Right Hemicolectomy Videos on YouTube

Introduction. Surgical technique videos are an important part of surgical fellows’ education. YouTube has been identified as the preferred source of educational videos among trainees . The aim of this article is to objectively evaluate the quality of the 50 most viewed videos on YouTube concerning right laparoscopic hemicolectomy using LAParoscopic surgery Video Educational GuidelineS (LAP-VEGaS). We hypothesized that the number of likes or views will not necessarily reciprocate with the educational content. Materials and methods. This observational study started with a YouTube search under the words “laparoscopic right hemicolectomy”, “right colectomy”, and “right hemicolectomy”. The 50 most viewed videos with an English title were chosen. Video characteristics and LAP-VEGaS score were analyzed by four colorectal surgery fellows from a tertiary center in Mexico City. Results. Right hemicolectomy videos were reviewed; there was no correlation between the LAP-VEGaS score and the view ratio, the like ratio, or the video power index. The LAP-VEGaS score was significantly higher among videos uploaded by medical associations, journals, or commercial when compared with videos uploaded by doctors/physicians or academic associations. Conclusion. Educational quality in right laparoscopic hemicolectomy videos did not reciprocate with their educational quality, but it agrees significantly with the video uploading source. Low educational quality was identified among the videos underscoring the need to endorse peer-reviewed video channels.

Aeromonas hydrophila endogenous endophthalmitis in a patient with underlying adenocarcinoma of the colon

An 83-year-old man presented with a red right eye, rapidly deteriorating vision and no history of ocular trauma or surgery. The patient had no vitritis on presentation, which confounded a diagnosis. Vitreous tap and injection of intravitreal antibiotics was performed day 2, however, the eye could not be saved and was surgically removed. Tissue culture reported Aeromonas hydrophila as the infective organism. Investigation into the source of infection revealed mural thickening of the caecum with CT of the abdomen. On completion of antibiotic treatment, the patient was referred for a colonoscopy, which revealed low grade adenocarcinoma of the colon, and subsequently underwent laparoscopic hemicolectomy. While the source of infection was unable to be identified, it is possible the infection seeded from the patients underlying malignancy. This case demonstrates the importance of thoroughly investigating patients with A. hydrophila endogenous endophthalmitis, as it can be an indication of underlying malignancy.

Extrakorporális és intrakorporális anasztomózis rövid távú eredményeinek összehasonlítása malignus daganat miatt végzett laparoszkópos jobb oldali hemikolektómia esetén

Összefoglaló. Bevezetés: A laparoszkópia térhódítása a jobb oldali colon műtéteknél is nyilvánvaló. Ma legtöbb helyen a laparoszkóposan asszisztált jobb oldali hemikolektómia extrakorporális anasztomózissal a gold standard. A morbiditás randomizált vizsgálatok alapján még 30% körüli. A technikai fejlődés lehetővé tette az intrakorporális anasztomózist. Célkitűzés: Retrospektív módon elemezni rosszindulatú jobb oldali vastagbéldaganat miatt végzett laparoszkópos hemikolektómiák rövid távú eredményeit a két módszer összehasonlításával. Eredmények: 2018. 01. 01. – 2019. 12. 31. között 184 jobb oldali hemikolektómiát végeztünk, ezek közül 122 történt malignus betegség miatt. 51 esetben nyitott és 71 esetben laparoszkópos műtét történt. 37 férfi (átlagéletkor: 70,59 év) és 34 nő (átlagéletkor: 72,14 év) volt. 50 esetben extrakorporális (EA) és 21 esetben pedig intrakorporális anasztomózist (IA) végeztünk. Az EA csoportban 18, míg az IA csoportban 3 szövődmény alakult ki 30 napon belül (p = 0,067). Az EA csoportból 3, az IA csoportból 1 beteget veszítettünk el 30 napon belül (p = 0,66). Az átlagos ápolási idő az EA csoportban 9,48 (5–32) nap, míg az IA csoportban 6,52 (4–19) nap volt (p = 0,001) a szövődményes esetekkel együtt. A szövődményes esetek nélkül az EA csoportban 6,35 (5–10) nap, az IA csoportban pedig 5,55 (4–8) napnak bizonyult (p = 0,09). A műtéti idő pedig az EA csoportban 147 (90–240) perc, az IA csoportban pedig 146,47 (90–265) perc volt (p = 0,11). Konklúzió: Az irodalommal összhangban azt találtuk, hogy IA esetén kevesebb a szövődmény, ezzel is összefüggésben rövidebb az átlagos ápolási idő, és a műtéti időt tekintve nincs szignifikáns különbség. Ezeket figyelembe véve az intrakorporális anasztomózis javasolható jobb oldali laparoszkópos hemikolektómia esetén. Summary. Introduction: Laparoscopy became evident for right-sided colon surgery too. Today the laparoscopic-assisted right-hemicolectomy is the gold standard with extracorporeal anastomosis. Morbidity according to randomized trials is still approximately 30%. The development of the surgical technique resulted in the creation of intracorporeal anastomosis. Our aim was to compare the short-term results of the two methods. Aim: To analyse the short-term results of right-sided hemicolectomy that were performed due to malignant tumours with the comparison of the two methods. Results: A cohort of 184 right-sided hemicolectomy were performed from 01.01.2018 to 31.12.2019 from which 122 were operated on because of a malignant disease. 51 open and 71 laparoscopic operations were performed. The average age of 37 men and 34 women were 70.59 and 72.14 years, respectively. 50 patients underwent extracorporeal (EA) anastomosis and 21 intracorporeal (IA) anastomosis. Within 30 days the number of complications were 18 in the EA group and 3 in the IA group (p = 0.067). 3 from the EA group and 1 from IA group died within 30 days (p = 0.66). The average length of stay were 9.48 days in the EA group and 6.52 days in the IA group together with the complicated cases (p = 0.001) while 6.35 days and 5.55 days without the complicated cases (p = 0.09). The average duration of operation was 147 minutes in the EA and 146.47 minutes in the IA group (p = 0.11). Conclusion: We found concordance with the literature that there are fewer complications in case of IA which might be related to shorter length of stay. There is no significant difference between the surgical times. Bearing these facts in mind, IA might be suggested for right- sided laparoscopic hemicolectomy.

New way of laparascopic intracorporeal term-terminal invagination ileotransverse anastomosis

Background. Laparoscopic surgery becomes a standard treatment for many surgical diseases. Defects of a stapler laparoscopic mechanical suture during the formation of an anastomosis after hemicolectomy are detected in 18% of observed cases.Objective. Development, substantiate reproducibility and safety of a manual intracorporeal term-terminal invagination ileotransverse anastomosis method after performing the right laparoscopic hemicolectomy.Material and Methods. Authors presented a description of the technique and their own experience of performing laparoscopic hemicolectomy on the right with the formation of a manual original anastomosis in 10 patients with pathology of the right half of the colon. Eight patients (80.0%) had a malignant tumor of the right half of the colon, 1 patient (10.0%) showed multiple polyps of the cecum and the ascending part of the colon, 1 patient (10.0%) developed a cystic-solid submucosa tumor of the ileocecal angle. One patient had metastatic lung disease at the time of establishing diagnosis. The postoperative follow-up period was 7-18 months.Result. There were no conversions to open surgery. All operations (n = 10) were ended completely laparoscopically - right hemicolectomy with standard D2 lymph node dissection. In one patient, we revealed intraoperatively the spread of the tumor to the gallbladder, which required additional cholecystectomy. The duration of the operation was 122.5±10.7 min.; median blood loss was 107±5.2 ml. At the time of follow-up all patients are alive.Conclusion. The technique is universal in the surgical treatment of patients with various pathologies of the right half of the colon.