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surgical intervention video

Similar to TME in rectal cancer, a comparable approach for the surgical resection of colonic cancers is described as complete mesocolic excision (CME), which includes central vascular ligation and dissection in the mesocolic space. According to a recently published Danish study, a 4-year disease-free survival (DFS) in the CME group was 85.8% whereas it was 75.9 % in the conventional group. Here, we present a video demonstration of laparoscopic right radical hemicolectomy in which complete mesocolic excision was performed. The mesocolic layer was identified as a shiny avascular film, which was preserved during the procedure in order to limit tumor dissemination. In this medial to lateral approach, the first duodenum is identified by incising the peritoneum and using a gauze piece for dissection purposes in an avascular plane, making sure to preserve the mesocolon. The right colic vessel is identified and clipped. The right branch of the middle colic artery and the ileocolic vessel are ligated. All fibrotic and adipose tissues are swept along with the specimen, and the ureter and gonadal vessels are dissected away. Lateral mobilization is achieved, and the specimen is then removed through small transverse incision to prepare for an extracorporeal ileo-transverse anastomosis.

Laparoscopic right hemicolectomy (mesocolic excision) in advanced right colonic tumor with parietal fixation (T4)

腹腔镜右半结肠切除术（结肠系膜切除术）治疗晚期右侧结肠肿瘤（T4）


Hémicolectomie laparoscopique droite (excision mésocolique) pour tumeur colique droite avancée avec fixation pariétale T4


Лапароскопическая правосторонняя гемиколэктомия (мезоколонэктомия) по поводу местно-распространенного рака правой половины ободочной кишки с врастанием в брюшную стенку (T4)


Hemicolectomía derecha laparoscópica (escisión del mesocolon) para cáncer avanzado en el colon derecho con fijación parietal (T4)


Hemicolectomia direita laparoscópica (excisão do mesocólon) para câncer avançado no cólon direito com fixação parietal (T4)


经肛门乙状结肠切除术与TEO™平台的腺癌


Трансанальная резекция сигмовидной кишки по поводу рака с использованием платформы TEO™ 


Sigmoïdectomie transanale avec plateforme TEO™ pour adénocarcinome


Sigmoidectomia transanal com plataforma TEO™ para adenocarcinoma


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.

Transanal sigmoidectomy with TEO™ platform for adenocarcinoma 

Sigmoidectomía transanal con plataforma TEO™ para adenocarcinoma


腹腔镜节段性乙状结肠切除术治疗结肠癌的方法：我如何做？


Лапароскопическая резекция сигмовидной кишки по поводу рака: мастер-класс


Sigmoidectomia segmentar laparoscópica para câncer de cólon: como faço?


The video entitled "Laparoscopic segmental sigmoidectomy for colon cancer: how I do it?", authored by J Leroy, A D'Urso, M Nedelcu, D Mutter, and J Marescaux is analyzed by Peter Marcello, MD (Lahey Clinic, Burlington, MA, United States), sharing his own personal experience and highlighting the different surgical approaches available with tips and tricks.

Laparoscopic segmental sigmoidectomy for colon cancer: how I do it? 

Sigmoïdectomie segmentaire laparoscopique pour cancer du côlon : méthodologie


Sigmoidectomía segmentaria laparoscópica para cáncer de colon: ¿cómo la hago?


Iatrogenic colonic perforation is a rare complication which has been reported in 0.03%-0.8% of cases during diagnostic colonoscopy. The sigmoid colon and the rectosigmoid junction are the most common sites of perforation during diagnostic examination. Successful endoscopic closure of the defect has been reported using standard clips. However, in case of large defects, standard clips are often ineffective. OTSC™ clips are devices which are successfully used to close wall defects up to 25mm. They make it possible to continue the endoscopic procedure after wall defect closure. In this video, we show the successful closure of a sigmoid colonic iatrogenic perforation in a 50-year-old woman by means of the Over The Scope Clip™ system (OVESCO® Endoscopy, Germany) (11/6 t) after failed attempt with standard clips. OVESCO™ was applied with a standard gastroscope using the suction technique by pushing the cap against the edges of the defect. In order to prevent incarceration of adjacent structures a soft aspiration of the omentum was applied and the OVESCO™ was carefully deployed. Carbon dioxide insufflation was used. Antibiotic therapy was started and the patient was discharged 5 days later. In conclusion, the Over The Scope Clip™ (OTSC™) is a safe surgery-sparing tool which allows for a successful iatrogenic perforation closure of the GI tract, performing omentoplasty by means of a suction technique. 

Successful closure of iatrogenic colonic perforation with Over-The-Scope Clip™ system (OVESCO™) after failed attempt with standard endoscopic clips

使用标准内窥镜剪辑失败后，使用Over-The-Scope Clip™系统（OVESCO™）成功关闭医源性结肠穿孔


Fechamento bem-sucedido da perfuração iatrogênica do cólon com sistema Over-The-Scope Clip™ (OVESCO™) após tentativa falha com clips endoscópicos padrão


Эффективность укрытия ятрогенной перфорации толстой кишки с помощью системы Over-The-Scope Clip™ (OVESCO™) после неуспешных попыток применения стандартных эндоскопических клипс


Fermeture réussie d’une perforation colique iatrogène à l’aide d’un dispositif Over-The-Scope Clip™ (OVESCO™) après essai infructueux avec des clips endoscopiques standards


Cierre exitoso de la perforación iatrogénica del colon con sistema Over-The-Scope Clip™ (OVESCO™) luego de intento frustrado con clips endoscópicos estándar


Мочеточнико-прямокишечная фистула: трансанальное закрытие с оментопластикой с помощью платформы TEO®


Fístula uretrorretal: reparo transanal com omentoplastia usando a plataforma TEO® 


Fistule urétrorectale : réparation transanale avec omentoplastie à l'aide du système TEO®


Urethrorectal fistula is a rare, though extremely invalidating complication after oncologic prostatectomy. The objective of this film is to demonstrate an original technique, respecting the anal sphincter, and using the TEO® platform in order to excise the fistula’s orifice and suture the different planes. The procedure is combined with an omentoplasty previously prepared laparoscopically. A stepwise demonstration is enhanced by external and internal HD views. 

Urethrorectal fistula: transanal repair with omentoplasty using the TEO® platform

尿道直肠瘘：使用TEO®平台进行肛门成形术


Fístula uretrorrectal: reparación transanal con omentoplastia utilizando la plataforma TEO® 


EPSiT (Tratamento Endoscópico do Cisto Pilonidal): nova abordagem original usando a plataforma de tratamento de fístulas anais assistida por vídeo (VAAFT)


Following Piercarlo Meinero’s original ideas to treat pilonidal sinus using the video-assisted anal fistula treatment (VAAFT) platform which he developed, we successfully performed this approach. This video shows different technical key points, which are essential to manage such chronic fistulas. 

EPSiT (Endoscopic Pilonidal Sinus Treatment): new original approach using the video-assisted anal fistula treatment (VAAFT) platform

Traitement EPSiT (traitement endoscopique du sinus pilonidal) : nouvelle approche utilisant la plateforme VAAFT (traitement vidéo-assisté de fistule anale)


EPSiT（Endoscopic Pilonidal Sinus Treatment）：使用视频辅助肛瘘治疗（VAAFT）平台的新颖原始方法


Лечение эпителиального копчикового хода с использованием платформы VAAFT (видео-ассистированное лечение анальных фистул)


EPSiT (Tratamiento Endoscópico del Quiste Pilonidal): nuevo abordaje original utilizando la plataforma de tratamiento de fístulas anales asistida por video (VAAFT)


Background: Transanal minimally invasive surgery has triggered much interest and investment in research over the last decade. This approach can be used not only to perform primary procedures (e.g., polypectomy, TME), but also to manage intraoperative complications such as leaks, bleedings, and late complications such as fistulas. 

Video: The first part of the video shows the repair of an immediate colorectal leak using transanal laparoscopy, in a 50-year-old woman who underwent a laparoscopic anterior resection of the rectum. During anastomotic control, a posterior leak 4cm away from the anal margin was found. A new transanal reusable port, named DAPRI Port or D-Port (Karl Storz Endoskope, Tuttlingen, Germany), along with DAPRI monocurved reusable instruments, was implemented. The second part of the video shows a persisting and symptomatic colorectal fistula, located posteriorly 11cm away from the anal margin, in a 65-year-old man who had undergone a laparoscopic anterior resection of the rectum 4 weeks earlier. 

Results: Operative time was 60 and 45 minutes respectively. Patients were discharged after 5 and 2 days respectively. Controls at 2 months (before ileostomy closure) showed a complete healing of the defects. 

Conclusions: Complications after anterior resection of the rectum, such as intraoperative leak and late colorectal fistula, can be treated using transanal laparoscopy. This new transanal platform offers surgeons the possibility to work in ergonomic positions without increasing the cost of the procedure thanks to the reusable nature of the material adopted. 

Laparoscopic repair of colorectal leak and fistula using a new transanal reusable platform

Reparo laparoscópico de extravasamento colorretal e fístula usando uma nova plataforma transanal reutilizável 


应用新型经肛门可重复使用平台的腹腔镜修复结直肠漏和瘘


Лапароскопическое ушивание свища колоректального анастомоза с использованием новой платформы для трансанального доступа


Reparación laparoscópica de fuga colorrectal y fístula utilizando una nueva plataforma transanal reutilizable 


Prise en charge laparoscopique de fistule colorectale : nouvelle plateforme transanale réutilisable


video lecture

Conseils : chirurgie ouverte - que peut-elle apprendre au laparoscopiste ? 


The laparoscopic approach in now considered the gold standard for many digestive procedures. In this key lecture, Professor Heald provides some interesting tips originating from the open approach which surgeons must keep in mind.

Tips: open surgery - anything to teach the laparoscopist?

Laparoscopic colorectal surgery comprises many different types of procedures for various diseases. In general, surgical complications can be divided into intraoperative and postoperative complications, and usually occur while the patient is still in the hospital. Over the recent decade, the improvement of different treatment strategies and technical inventions  has been tremendous. This is mainly attributable to the increase use of the laparoscopic approach, which is now well-accepted for many procedures. Training of the surgeon, hospital volume, and learning curves are becoming increasingly more important to maximize patient safety, surgeon expertise, and cost-effectiveness. The standardization of perioperative care is essential to minimize postoperative complications. In this key lecture, Dr. Barry Salky provides an overview, namely how to identify and minimize intraoperative and postoperative complications.

Can we reduce complications in laparoscopic colorectal surgery? 

Peut-on réduire les complications en chirurgie colorectale laparoscopique ? 


Chirurgie endo-laparoscopique : moins, c'est plus


Large colonic polyps and those on or behind a haustral fold can be very challenging to remove. EMR and ESD are performed for such polyps. In some selected cases, a combined endoscopic and laparoscopic approach (CELS) can be performed. In this lecture, Dr. Marcello outlines this approach.

Combined endo-laparoscopic surgery: less is more

Endometriosis is not an oncological disease but the involvemement of bowel sometimes requires an invasive approach. In this ley lecture, Professor Joël Leroy highlights the role of the digestive surgeon in the surgical management of endometriosis. 

Deep infiltrating endometriosis: the role of the general and digestive colorectal surgeon

Endométriose pelvienne profonde : le rôle du chirurgien général digestif et colorectal


A microcirurgia endoscópica transanal (TEM) é agora aceita para pólipos benignos que não são favoráveis à ressecção colonoscópica e para carcinoma precoce do reto.Nesta palestra magistral, a Dra. Habr-Gama destaca as aplicações atuais desta abordagem.


TEM: ancestral do NOTES, mas ainda muito útil

TEM : l'ancêtre de NOTES, mais encore très utile


Transanal endoscopic microsurgery (TEM) is now accepted for benign polyps which are not amenable to colonoscopic resection and for early carcinoma of the rectum. In this key lecture, Dr. Habr-Gama outlines the current applications of this approach.

TEM: ancestor of NOTES but still very useful 

Transanal TME is a new approach used to perform minimally invasive rectal resection. It is particularly well-suited for patients with locally advanced distal rectal cancer and obesity, where the abdominal approach is challenging. In this key lecture, Professor Heald shows some video demonstrations of the ''Bottom up'' approach. 

Transanal minimally invasive surgery for total mesorectal excision (TAMIS TME) or ''bottom up''

Chirurgie transanale mini-invasive pour excision mésorectale totale (TAMIS TME), ou technique "bottom up"


"A TME transanal é uma nova abordagem utilizada para realizar a ressecção minimamente invasiva do reto.É particularmente adequada para os pacientes com câncer de reto distal avançado e obesidade, nos quais a abordagem abdominal é desafiadora.Nesta palestra magistral, o Professor Heald demonstra alguns vídeos da abordagem ""Bottom up"" (de baixo para cima)."


"Cirurgia transanal minimamente invasiva para excisão total do mesorreto (TAMIS TME) ou ""de baixo para cima"""

В центре внимания - колоректальная хирургия


Focus On Colorectal Surgery! 

Focus sur la chirurgie colorectale
