By William C S Meng, Hester Y S Cheung, David T Y Lam, Simon S M Ng
In this e-book, pioneers and unusual masters of surgical procedure describe novel minimally invasive colo- and anorectal strategies which were constructed in Asia yet are of foreign applicability. The awarded recommendations are large ranging in nature and relate to colon surgical procedure, rectal surgical procedure and the therapy of hemorrhoids, fistulas and persistent constipation. every one method is punctiliously defined by way of top quality colour photos and illustrations, drawing awareness to many functional tips and tips. as well as the ideas themselves, state-of-the-art expertise is brought that's now being utilized clinically in China, Hong Kong, Asia-Pacific, and past. The publication will let readers either to know the ideas underlying those very important new techniques and advances and to breed the thoughts of their personal surgical practice.
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Additional info for Minimally Invasive Coloproctology: Advances in Techniques and Technology
4) Late stage tumours cannot be excised laparoscopically. It is not feasible to resect T4 lesions, and conversion is required for most of these cases. (5) Bleeding has been a dreaded case, where conversion has often been necessary. With technical improvement and technological advancement, in particular with the appearance of the ultrasonic dissector, laparoscopic colorectal resection has steadily become another commonly performed complex surgery following laparoscopic cholecystectomy. J. L. com Successful extirpation of a tumour depends on the degree of tumour differentiation, staging, extent of surgical excision, no-touch technique and integrated post-operative care.
The main disadvantage is the “chopsticks” effect and more frequent clashing of both hands. These difficulties can be overcome by the “cross hand technique” which will be elaborated in the next section. 4 Operative Technique A transumbilical incision is usually chosen because the scar can be hidden within the umbilicus and it gives best cosmetic result (Fig. 2). A transumbilical incision also provides easy and fast access to peritoneal cavity via open cut down technique because the peritoneum is adherent to umbilicus and requires no extra dissection.
The arm should remain in a neutral position in order to reduce fatigue. The non-dominant hand is inserted just beyond the wrist into the abdomen, leaving the dominant hand to handle laparoscopic instruments. • The specimen should be recovered inside a specimen bag or through a protected wound in order to avoid contacting the wound edges. 2 training of laparoscopic surgeons, or it can be a strategy for a seasoned surgeon to handle difficult cases. Prospective randomised trial is needed in order to establish the relative role of HALS and standard laparoscopic surgery.