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Laparoscopic resection rectopexy for rectal prolapse
a p o l l o m e d i c i n e 1 2 s ( 2 0 1 5 ) S7–S9
Available online at www.sciencedirect.com
ScienceDirect journal homepage: www.elsevier.com/locate/apme
Videos
Laparoscopic resection rectopexy for rectal prolapse
Robotic anterior resection – Video presentation
Kumar Parth, G. Srikanth
Arun Prasad, Mandeep Kaur
Department of Surgical Gastroenterology, BGS Global Hospital, Bangalore, India
Indraprastha Apollo Hospitals, Delhi, India
Introduction: The laparoscopic approach in suture rectopexy with sigmoid resection is appealing as surgery is mainly confined to the pelvis. Material & methods: The procedure is performed in modified lithotomy position using four trocars. The sigmoid colon is mobilized medially and may be mobilized laterally up to the descending colon, depending on the extent of resection. Superior hemorrhoidal artery was preserved. The splenic flexure remains in place. The rectum is mobilized from the presacral fascia down to the pelvic floor, sparing the hypogastric nerves. The rectum is transected in its upper third (recto-sigmoid junction) and the colonic stump pulled outside after enlarging the left lower abdominal incision to a length of 5 cm. The colorectal anastomosis is established intracorporeally in a double-stapling technique. Three 2-0 nonabsorbable sutures (polypropylene) were placed to attach the right lateral stalks of the rectum to the presacral fascia. Proctoscopic examination has to ensure that there is no luminal compromise or air leakage. Results: The video presentation is about a 42-year-old male patient with a rectal prolapse of 6 cm in length. First symptoms had occurred in childhood. He reported about temporary constipation and repeated rectal bleeding. He had history of undergoing open rectopexy at the age of 24, but had recurrence following 6 months of procedure. There were no intraoperative or postoperative complications. The patient was discharged from the hospital on the fifth postoperative day. Conclusion: Laparoscopic resection rectopexy is safely feasible as a minimally-invasive treatment option for rectal prolapse. http://dx.doi.org/10.1016/j.apme.2015.11.022
0976-0016/$ – see front matter
Introduction: Robotic surgery has definitive benefits in the pelvic surgeries, e.g. gynecology, oncology, colorectal procedures. I am presenting the technique of robotic anterior resection. Method: A 53-year-old gentleman was diagnosed to have rectal cancer. Low anterior resection and colorectal anastomosis was planned. Patient placed in supine position. Ports were placed taking care to avoid clashing of the instruments. Low anterior resection was done taking adequate margin. Hemostasis was secured throughout the procedure. Result: Post-operative recovery was uneventful and patient was discharged on post op day 5. Discussion: Robotic pelvic surgery has definitive benefit in terms of accessibility of structures in narrow pelvis due to flexible instruments and improved vision. Here by I present the technique of robotic low anterior resection. http://dx.doi.org/10.1016/j.apme.2015.11.023 Laparoscopic sleeve resection for a caecal GIST Prateek Agarwal, Rashmi Pyasi, A.K. Kriplani We had a middle aged lady who was planned for a limited resection SOS right hemicolectomy by laparoscopy on detection of a caecal GIST. The interesting position of the tumour prompted us to do a local resection and it makes for an interesting video on how to minimize the surgery effectively when needed. http://dx.doi.org/10.1016/j.apme.2015.11.024
Available online at www.sciencedirect.com
ScienceDirect journal homepage: www.elsevier.com/locate/apme
Videos
Laparoscopic resection rectopexy for rectal prolapse
Robotic anterior resection – Video presentation
Kumar Parth, G. Srikanth
Arun Prasad, Mandeep Kaur
Department of Surgical Gastroenterology, BGS Global Hospital, Bangalore, India
Indraprastha Apollo Hospitals, Delhi, India
Introduction: The laparoscopic approach in suture rectopexy with sigmoid resection is appealing as surgery is mainly confined to the pelvis. Material & methods: The procedure is performed in modified lithotomy position using four trocars. The sigmoid colon is mobilized medially and may be mobilized laterally up to the descending colon, depending on the extent of resection. Superior hemorrhoidal artery was preserved. The splenic flexure remains in place. The rectum is mobilized from the presacral fascia down to the pelvic floor, sparing the hypogastric nerves. The rectum is transected in its upper third (recto-sigmoid junction) and the colonic stump pulled outside after enlarging the left lower abdominal incision to a length of 5 cm. The colorectal anastomosis is established intracorporeally in a double-stapling technique. Three 2-0 nonabsorbable sutures (polypropylene) were placed to attach the right lateral stalks of the rectum to the presacral fascia. Proctoscopic examination has to ensure that there is no luminal compromise or air leakage. Results: The video presentation is about a 42-year-old male patient with a rectal prolapse of 6 cm in length. First symptoms had occurred in childhood. He reported about temporary constipation and repeated rectal bleeding. He had history of undergoing open rectopexy at the age of 24, but had recurrence following 6 months of procedure. There were no intraoperative or postoperative complications. The patient was discharged from the hospital on the fifth postoperative day. Conclusion: Laparoscopic resection rectopexy is safely feasible as a minimally-invasive treatment option for rectal prolapse. http://dx.doi.org/10.1016/j.apme.2015.11.022
0976-0016/$ – see front matter
Introduction: Robotic surgery has definitive benefits in the pelvic surgeries, e.g. gynecology, oncology, colorectal procedures. I am presenting the technique of robotic anterior resection. Method: A 53-year-old gentleman was diagnosed to have rectal cancer. Low anterior resection and colorectal anastomosis was planned. Patient placed in supine position. Ports were placed taking care to avoid clashing of the instruments. Low anterior resection was done taking adequate margin. Hemostasis was secured throughout the procedure. Result: Post-operative recovery was uneventful and patient was discharged on post op day 5. Discussion: Robotic pelvic surgery has definitive benefit in terms of accessibility of structures in narrow pelvis due to flexible instruments and improved vision. Here by I present the technique of robotic low anterior resection. http://dx.doi.org/10.1016/j.apme.2015.11.023 Laparoscopic sleeve resection for a caecal GIST Prateek Agarwal, Rashmi Pyasi, A.K. Kriplani We had a middle aged lady who was planned for a limited resection SOS right hemicolectomy by laparoscopy on detection of a caecal GIST. The interesting position of the tumour prompted us to do a local resection and it makes for an interesting video on how to minimize the surgery effectively when needed. http://dx.doi.org/10.1016/j.apme.2015.11.024