Hellow guys, Welcome to my website, and you are watching Laparoscopic complete mobilization of the sigmoid colon & the rectum in a female patient. and this vIdeo is uploaded by Cancer Surgery Masterclass at 2020-02-02T21:31:30-08:00. We are pramote this video only for entertainment and educational perpose only. So, I hop you like our website.
| Name | Laparoscopic complete mobilization of the sigmoid colon & the rectum in a female patient |
| Video Uploader | Video From Cancer Surgery Masterclass |
| Upload Date | This Video Uploaded At 03-02-2020 05:31:30 |
| Video Discription | Hello everyone, Today let's look at the video presentation of laparoscopic complete sigmoid & rectal mobilization in a female patient. In the female patient the very first thing is to lift the uterus up using a suture which is introduced via the anterior abdominal wall preferably using a straight needle. The next step is to incise the peritoneum just above the lower part of abdominal aorta & to proceed cranially till we can see the pulsations of the inferior mesenteric artery. The fatty tissue dissection around the IMA must be done about 3 cm above it’s origin to avoid damage to the inferior mesenteric plexus. In the still image you can see a nerve fiber passing laterally close to the origin of the IMA. The left ureter can be seen now & therefore note that our plane of dissection must be just inferior to the IMA & IMV & then going anterior to the gonadal vessels & the left ureter. After dividing the IMA, the IMV must be found lateral to it & then divided. The dissection is continued over the left ureter & the gonadal vessels till the peritoneal leaflet anterior to the Psoas muscle is breached. Then comes the lateral dissection. The left ureter is again exposed laterally & traced as it enters the pelvis. The dissection again commenced medially & the peritoneum is incised up to the pelvic brim. Posterior dissection is carried out in the Holy plane as far as possible. See that we use the energy device to both cut & push the tissues away during the dissection. The patient had underwent neoadjuvant chemo-irradiation where an old fashioned Cobalt machine was used in a peripheral hospital. So there was significant radiation induced fibrosis. The peritoneal folds from left & right curving over the recto-uterine pouch is incised. Before one commences the anterior dissection, bear in mind to develop the least demarcated lateral planes of the mesorectum which is done in close proximity to the inferior hypogastric plexus. The anterior dissection in the female is easier than in males due to the fact that the pelvis being broader & the vagina replacing the seminal vesicles & the prostate in females. If one intends to do very low anterior resections, intersphincteric resections or abdominoperineal resections, it is essential to reach the pelvic floor right around the lower most rectum, except anteriorly. Anteriorly the dissection must be carried out up to the lowermost part of the posterior vaginal wall. Finally you can see that the lowermost part of the rectum is hardly enclosed in fat & can be seen as a muscular tube. This channel is dedicated to everyone who is interested in the field of Oncological surgery & is conducted by Dr. Anuruddha Thewarapperuma MBBS MS, a Consultant Cancer Surgeon from Sri Lanka. This includes a series of video classes & lectures on operative surgery with illustrations, valuable tips and advice. Please feel free to comment, give suggestions & ask questions in the comment section below. We hope this channel will be thought provoking and inspiring to all the surgeons, medical students, aspiring doctors, nurses and anyone in the surgical community who is interested in Cancer Surgery. We wish you all the best! Thank you! Contact us cancersurgerymasterclass@gmail.com |
| Category | Education |
| Tags | Cancer surgery | Oncology | Oncological surgery | surgery lectures | video class | surgeons | doctors | Medstar Health | Operation | Breast cancer | Thyroid cancer | Lung cancer | Esophageal cancer | Head & neck cancer | Gastric cancer | Colon cancer | Liver cancer | Pancreatic cancer | Uterine cancer | Ovarian cancer | Prostate cancer | Bowel cancer | Bone cancer | Skin cancer | Armando Hasudungan | John Gilmore M.D. | Dr. Najeeb Lectures | Osmosis | Laparoscopic surgery | rectal cancer | sigmoidectomy |
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