Laparoscopic Right Hemicolectomy with Isoperistaltic Intracorporeal Anastomosis

Video Type: CVideo
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Author: David Schwartzberg
Published:
Specialties: General Surgery
Schools: New York University Langone Medical Center
Views: 661
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Basic Info

Authors: David Schwartzberg, Noah Cohen, Jordan Schwartzberg, Paresh C. Shah

Oncologic outcomes of laparoscopic and open colectomy have been demonstrated to be equivalent, with similar three-year disease-free survival and overall survival rates for any stage. Compared to patients who undergo open colectomy, patients who undergo laparoscopic colectomy benefit from a shorter median length of hospital stay and decreased post-operative use of pain medication. Intraoperative and post-operative complications are similar between open and laparoscopic colectomy.
 
A Comparison of Laparoscopically Assisted and Open Colectomy for Colon Cancer. The Clinical Outcomes of Surgical Therapy Study Group. N Engl J Med 2004;350:2050-9
 
Advanced

Procedure

Laparoscopic right colectomy

Indications

Right-sided colon and appendiceal neoplasms, colonoscopically unresectable polyps, ileocolic Crohn�s disease, cecal volvulus, right-sided diverticulitis

Contraindications

Any contraindication to laparoscopy

Instrumentation

Setup

Supine, left arm tucked

Preoperative Workup

Colonoscopy, cross-sectional abdominopelvic imaging, and routine preoperative lab work including carcinoembryonic antigen (CEA)

Anatomy and Landmarks

Right ureter, duodenum, ileocolic pedicle, right colic artery, and right branch of middle colic arteries

Advantages/Disadvantages

Laparoscopic advantages include less post-operative pain and shorter length of stay

Complications/Risks

General concerns of bleeding, infection, anastomotic leak, and damage to nearby organs, with operative-specific injuries to the ureter, duodenum, liver, and contents of the hepatoduodenal ligament

Disclosure of Conflicts

General concerns of bleeding, infection, anastomotic leak, and damage to nearby organs, with operative-specific injuries to the ureter, duodenum, liver, and contents of the hepatoduodenal ligament

Acknowledgements

NYU Langone Medical Center

References

A Comparison of Laparoscopically Assisted and Open Colectomy for Colon Cancer. The Clinical Outcomes of Surgical Therapy Study Group. N Engl J Med 2004;350:2050-9.

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