A tunnel approach in laparoscopically assisted radical right hemicolectomy – a video vignette

Zhang, Xijie; Zhang, J. L.; Li, S.; Ma, P. F.; Zhao, Yuzhou

doi:10.1111/codi.14977

Cited by 4 publications

(3 citation statements)

References 7 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…When the lower edge of the rectal tumour is particularly close to the anus, we perform a laparoscopic total proctocolectomy and ileostomy. This video suggests that the laparoscopic radical total proctocolectomy approach should be performed in three stages: radical right hemicolectomy performed by the tunnel method [6], radical left hemicolectomy by a medial to lateral approach guided by the inferior mesenteric vein and radical proctectomy by the Miles method of TME. The advantages of this approach are as follows.…”

Section: Total Mesorectal Excision (Tme) and Complete Dissociation Of...mentioning

confidence: 99%

Laparoscopic clockwise three‐stage radical total proctocolectomy – a video vignette

Zhang

Cao

et al. 2020

Colorectal Disease

Self Cite

View full text Add to dashboard Cite

and submucosa is carried out with the jaws as close to the anal canal wall as possible, dissecting the haemorrhoidal plexus off the fibres of the internal anal sphincter. Finally, with the LigaSure TM Small Jaw Open Sealer, the haemorrhoidal pedicle is reached and the haemorrhoidal tissue is freed from the internal sphincter muscle fibres at this level. With the jaws of the device applied perpendicularly, the pedicle is divided. The wound is checked for haemostasis. The same manoeuvre is performed when excising the remaining two haemorrhoidal complexes. It is crucial to preserve intact tissues between excisional wounds in the anal canal and perianal skin between sites of incision of another haemorrhoidal complex. The size of the excisional wound should be equal to or less than the width of the mucocutaneous bridge. This method is used to avoid postoperative stricture. Postoperative follow-up of the patient at 1 month showed high efficacy of the procedure. This technique avoids any suturing, thus minimizing pain and intra-operative complications.

show abstract

Section: Total Mesorectal Excision (Tme) and Complete Dissociation Of...mentioning

confidence: 99%

Laparoscopic clockwise three‐stage radical total proctocolectomy – a video vignette

Zhang

Cao

et al. 2020

Colorectal Disease

Self Cite

View full text Add to dashboard Cite

show abstract

“…TA begins by dissociating the attachment of the ileocecal region and the retroperitoneum and forms a tunnel upward through Toldt’s gap, making it easier to expose the superior mesentery vessels. Previous studies have shown that TA has achieved satisfactory clinical results [ 16 ]. This study aimed to explore the surgical feasibility and safety of the TA in comparison to the MA in laparoscopic right hemicolectomy.…”

Section: Introductionmentioning

confidence: 99%

Tunnel versus medial approach in laparoscopic radical right hemicolectomy for right colon cancer: a retrospective cohort study

Zhang

et al. 2022

BMC Surg

View full text Add to dashboard Cite

Purpose This study aimed to explore the feasibility and safety of the tunnel approach in laparoscopic radical right hemicolectomy for colon cancer. Methods From July 2016 to October 2018, a total of 106 consecutive patients with colon cancer who underwent laparoscopic radical right hemicolectomy at the Affiliated Cancer Hospital of Zhengzhou University were enrolled. The patients were stratified into either a tunnel approach (TA) (n = 56) group or traditional medial approach (MA) (n = 50) group according to the surgical technique performed. The baseline demographics, perioperative outcomes and oncologic outcomes were compared between the two groups. Results The baseline characteristics did not differ between groups. The TA group had significantly less blood loss [20.0 (10.0–40.0) vs. 100 (100.0–150.0) ml, p < 0.001] and a shorter operation time [128.4 ± 16.7 vs. 145.6 ± 20.3 min, p < 0.001] than the MA group. The time to first flatus and postoperative hospital stay were similar [3.0 (2.0–4.0) vs. 3.0 (3–4.0) days, p = 0.329; 10.4 ± 2.6 vs. 10.7 ± 3.0 days, p = 0.506] between the two groups. The conversion to laparotomy and complication rates were similar between groups (0 vs. 6.0%, p = 0.203; 14.3% vs. 18.0%, p = 0.603, respectively). No treatment-related deaths occurred in either group. The TA group did not have significantly better survival outcomes than the MA group (p = 0.372). Conclusions The TA seems to allow for more favourable results in terms of blood loss and operative time than the MA, with similar results regarding time to first flatus, hospital stay, postoperative complication rate, conversion rate and oncologic outcomes; moreover, the TA is easier for beginners to master.

show abstract

“…However, the medial-to-lateral approach laparoscopic right hemicolectomy is a demanding procedure with a steep learning curve and has a high rate of conversion to laparotomy, the main reason is anatomic complexity numerous variation of right colonic vessels [14,15] . Thus, we design the tunnel type lower right approach to finish the complete mesocolic excision (CME) based on the operation idea of "Easier surgery" and have achieved satisfactory clinical results [16] . The aim of this study is to compare the surgical feasibility and safety with this new surgical approach performed.…”

Section: Introductionmentioning

confidence: 99%

The tunnel approach versus medial approach in laparoscopic radical right hemicolectomy for colon cancer: A retrospective cohort study

zhang¹,

Zhang²,

Ma³

et al. 2020

Preprint

View full text Add to dashboard Cite

Background: Although Multiple studies showed that the median approach is nowadays the most widely accepted approach according to the “no-touch” principle and safety. However, this approach is a demanding procedure with a steep learning curve and has a high rate of conversion to laparotomy. This aim is to explore the feasibility and safety of tunnel approach in laparoscopic radical right hemicolectomy for colon cancer.Methods：From July 2016 to October 2018, a total of 106 consecutive patients with colon cancer who were subjected to the laparoscopic radical right hemicolectomy in the affiliated cancer hospital of zhengzhou university were enrolled. The patients underwent either tunnel approach (TA) (n=56) or traditional medial approach (MA) (n=50) according to the surgical maneuver performed. The patients' baseline demographics and perioperative results were compared between the two groups.Results: The baseline characteristics did not differ between groups. The blood loss was significantly less [20.0(5.0-40.0) vs. 100(50.0-150.0) , p < 0.001] and operation time was significantly shorter [128.4±16.7 vs. 145.6±20.3min, p < 0.001]in the TA group than those in MA group. Time to first flatus and postoperative hospital stay were similar [3.0(2.0-4.0) vs. 3.0(3-4.0)d，p=0.329; 10.4±2.6 vs. 10.7±3.0d，p=0.506] in both groups. The conversion to laparotomy and complication rates were similar between the groups(0 vs. 6.0%, p = 0.203; 14.3% vs. 18.0%, p =0.603,respectively). There was no treatment-related death in both groups.Conclusions: The tunnel approach in laparoscopic radical right hemicolectomy for colon cancer is a technically feasible and safe procedure as a preferable approach at present compared to those of medial approach, meanwhile this method is easier for beginners to master. Hence this tunnel approach right hemicolectomy is worth recommended.

show abstract

A tunnel approach in laparoscopically assisted radical right hemicolectomy – a video vignette

Cited by 4 publications

References 7 publications

Laparoscopic clockwise three‐stage radical total proctocolectomy – a video vignette

Laparoscopic clockwise three‐stage radical total proctocolectomy – a video vignette

Tunnel versus medial approach in laparoscopic radical right hemicolectomy for right colon cancer: a retrospective cohort study

The tunnel approach versus medial approach in laparoscopic radical right hemicolectomy for colon cancer: A retrospective cohort study

Contact Info

Product

Resources

About