slawomir marecik, md, facs, fascrs advocate lutheran general hospital, park ridge, il clinical...
TRANSCRIPT
COLORECTAL and robotic SURGERIES
Slawomir Marecik, MD, FACS, FASCRSAdvocate Lutheran General Hospital, Park Ridge, ILClinical Assistant ProfessorUniversity of Illinois, Chicago, USA
Outline Anatomy Colon cancer Rectal cancer Diverticular disease Inflammatory bowel disease
Crohn’s disease Ulcerative colitis
Anatomy How long is your colon?
Anatomy picture of the colon lymph nodes vessels retroperitoneal part perforations
Anatomy video full colon inside live
Anatomy video of right colon specimen video of left colon and rectum specimen
Colon cancer pictures right colon transverse left colon sigmoid
Colon cancer
Colon cancer type of operations type of anastomosis how the anastomosis is created stapling
Type of anastomosis Hand-sewn Stapled
Linear stapler Circular stapler
Hand-sewn anastomosis
Stapled, linear
Stapled, circular
Colon cancer When is colostomy needed?
emergency situation when… bowel is not prepared (bowel prep) patient has no healing potential
poor nutrition poor vascular supply steroids, other severe conditions
Rectal cancer Anatomy
mesorectum, valves, lymph nodes sphincter
Rectal cancer Level of tumor
Type of operations endoscopic excision local (transanal) excision radical surgery (involving bowel and lymph
nodes) radical surgery with sphincter
ANTERIOR RESECTION
ULTRALOW ANTERIOR RESECTION
LOW ANTERIOR RESECTION
COLOANALPULLTHROUGH
Rectal cancer When is colostomy needed?
tumor involving the sphincter poor preoperative continence
When is (protective) ileostomy needed? low pelvic anastomosis if radiation was given before surgery
Need for proper evaluation endoscopy ultrasound MRI
Types of reconstruction after rectal cancer surgery
Straight connection J pouch Side to end
video
preoperative chemoradiation therapy when? how long? why ileostomy? why pouchogram and flex sig?
Video – rectal cancer surgery Total mesorectal excision