By William C S Meng, Hester Y S Cheung, David T Y Lam, Simon S M Ng
In this publication, pioneers and exclusive masters of surgical procedure describe novel minimally invasive colo- and anorectal strategies which have been built in Asia yet are of foreign applicability. The provided concepts are extensive ranging in nature and relate to colon surgical procedure, rectal surgical procedure and the therapy of hemorrhoids, fistulas and protracted constipation. each one strategy is punctiliously defined using top of the range colour photos and illustrations, drawing recognition to many sensible counsel and methods. as well as the options themselves, cutting-edge know-how is brought that's now being utilized clinically in China, Hong Kong, Asia-Pacific, and past. The publication will let readers either to understand the options underlying those very important new methods and advances and to breed the strategies of their personal surgical practice.
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HALS has a finite complication rate, especially burns injury from the heat of ultrasonic dissector. Movement of the operating hand in the peritoneal cavity may inadvertently come into contact with the laparoscopic lens, thereby blurring it. To avoid such inconvenience, good cooperation between the surgeon and the camera man is needed. The hand can cause structures to bleed, and increases the risk of future adhesions. Trocar site tumour implantation remains an issue of concern in the development of laparoscopic surgery.
7. 8. and right ureters during dissection. The inferior mesenteric artery (IMA) and vein are exposed, and the lymph nodes at the IMA root is taken into the specimen side. The IMA or the superior rectal artery is divided together with their accompanying veins. Care should be taken to preserve left colic artery in order to avoid inadequate blood supply to the anastomotic and the consequential leak. Sharp dissection in the ‘holy plane’ between the mesorectal fascia and the pelvic fascia. In the case of low rectal tumour, dissection should be carried down to the tip of the coccyx.
The free end of the sigmoid colon is then grasped with a endoscopic grasper with lock. The sigmoid colon is ready to be extricated from the abdominal cavity. The laparoscope is then removed and the abdomen desufflated. The left lower quadrant port site is then extended to about 4 cm or a size of wound through which the sigmoid colon with the tumor can get through 3 Laparoscopic Colectomy Fig. 3 Sigmoid colon transection without excessive traction force. A wound protector usually in the form of a plastic sleeve is then applied to the extended port site and the sigmoid colon is then retrieved from the abdomen with the cut free end coming out first.