with Dr. Antonio M. Lacy
Dr. Antonio M. Lacy performs a laparoscopic right hemicolectomy to a 86-year-old male patient, diagnosed with an unresectable polyp of the cecum after diagnostic colonoscopy.
Case Record:
Clinical Background
Male, 86 years old
Unresectable polyp of the cecum with HGD
Technique Description
Clinical History:
86-year-old male patient, diagnosed with an unresectable polyp of the cecum after diagnostic colonoscopy.
Biopsy: high-grade dysplasia
Proposed for pre-habilitation followed by conventional laparoscopic Right Colectomy.
Other History:
Medical History: Hypertension, Type 2 Diabetes, Atrial Fibrillation, Heart Failure, Stage III Chronic Kidney disease, Pulmonary dysfunction
Surgical History: no previous surgeries
Procedure Steps:
Construction of the pneumoperitoneum with Veress needle
Placement of an umbilical optical trocar followed by 4 working trocars: 5mm epigastrium and right upper and lower quadrants, 12 mm hypogastrium
Inspection of the abdominal cavity
Approach of the ileocolic vessels in a medial-to-lateral approach and ligation about 1cm from the origin
Dissection of the posterior plane without disruption of the mesocolic fascia and leaving the duodenum and right ureter.
Dissection of the mesocolon and mesentery of the terminal ileum
Transection of the transverse colon and the terminal ileon and construction of an antiperistaltic latero-lateral stappled anastomosis after confirmation of vascularization with ICG.
Trocar revision and extraction of the specimen.
Learning Points: Dissection of the supplying vesselsDissection of the posterior plane without disruption of the mesocolic fasciaHow to perform an intracorporeal anastomosis
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