What are the risks of laparoscopic colorectal surgery?

Carcinoma of the splenic flexure is a rare condition accounting for approximately 3 to 8% of colon cancers. The surgical treatment is challenging and not fully standardized. This video demonstrates a laparoscopic segmental oncologic splenic flexure colonic resection for cancer.

This video shows a unique procedure during which a sigmoidectomy was performed with a single trocar and entirely through the umbilicus. The principles applied to benign colonic resections are respected. An original colo-colonic anastomosis is presented with the use of external magnets to aid in with the totally intracorporeal anastomosis. The postoperative cosmetic results are shown.

The objective of this film is to demonstrate the operative strategy in case of bleeding in contact to large vessels, and here the superior mesenteric vein following division of the ileocolic vessels.

This video demonstrates the laparoscopic approach to sigmoid resection following previous attacks of diverticulitis. The medial vascular approach is employed, although in this case the inferior mesenteric artery is preserved. Obesity presents particular problems of reduced space and difficulty in identification of structures because of visceral adiposity. This video is suitable for advanced laparoscopic digestive surgeons.

The authors use the medial vascular approach, preserving the inferior mesenteric artery. The obese patient presents the dual challenge of reduced space and difficulty in identifying structures. The authors gain exposure of the mesosigmoid, and initially incise the peritoneum to divide the vessels, respecting the superior rectal vessels. They divide only the sigmoid vessels to preserve the superior rectal artery and vein.

In this lecture, Dr. Gina Brown discusses the interest of MRI restaging after neoadjuvant treatment for rectal cancer.

The objective of this film is to demonstrate a wedge resection of the right anterior colonic wall carried out to manage a flat polyp. A Surgiquest™ Airseal™ 12mm trocar is used for that purpose, along with two other trocars: a suprapubic trocar and an epigastric trocar. Two 12mm trocars are used: one of them is placed at the level of the umbilicus, and the other one is positioned in the epigastric region. The third trocar is a 5mm one. It will be placed in a suprapubic position.

The video entitled "Transanal sigmoidectomy with TEO™ platform for adenocarcinoma", authored by J Leroy, A D'Urso, D Mutter, and J Marescaux is analyzed by Richard Whelan, MD (St. Luke's-Roosevelt Hospital Center, New York, NY, United States), sharing in this way his own personal experience and highlighting the different surgical approaches available with tips and tricks.

This video demonstrates the dissection of the vascular anatomy of the right colon for a right hemicolectomy. The surgeon uses a medial approach to mesenteric mobilization to show an excellent dissection of ileocolic, right and middle colic vessels.