M J F X Rickard1,2, A Keshava1,2, J W T Toh3,4. 1. Colorectal Division, Department of Surgery, Concord Hospital, Concord, NSW, 2139, Australia. 2. Department of Surgery, Macquarie University Hospital, Macquarie, NSW, 2113, Australia. 3. Colorectal Division, Department of Surgery, Concord Hospital, Concord, NSW, 2139, Australia. james.toh@health.nsw.gov.au. 4. Colorectal Division, Department of Surgery, Westmead Hospital, Westmead, NSW, 2145, Australia. james.toh@health.nsw.gov.au.
Abstract
BACKGROUND: To provide a standardised 'medial to lateral' approach to laparoscopic colorectal surgery. METHODS: Both right- and left- sided laparoscopic colorectal procedures were simplified into three well-defined steps and a join. An instructional video and procedural guide provides the important pearls and pitfalls in performing laparoscopic colorectal surgery. RESULTS: During a 10-year period (2006-2016) at a single institution, 20 senior colorectal trainee surgeons and 20 general surgery registrars were trained in the 'three steps and a join' technique. Five hundred and sixty-eight laparoscopic anterior resections using this technique were performed. There were 5 (0.9%) leaks. Five hundred and forty-three laparoscopic right-sided resections were performed. There were 3 (0.6%) anastomotic leaks requiring reoperation and loop ileostomy. CONCLUSIONS: This step-by-step instructional video and procedural guide provides a simple and standardised approach which may be incorporated into a training pathway for laparoscopic right- and left-sided colorectal surgery.
BACKGROUND: To provide a standardised 'medial to lateral' approach to laparoscopic colorectal surgery. METHODS: Both right- and left- sided laparoscopic colorectal procedures were simplified into three well-defined steps and a join. An instructional video and procedural guide provides the important pearls and pitfalls in performing laparoscopic colorectal surgery. RESULTS: During a 10-year period (2006-2016) at a single institution, 20 senior colorectal trainee surgeons and 20 general surgery registrars were trained in the 'three steps and a join' technique. Five hundred and sixty-eight laparoscopic anterior resections using this technique were performed. There were 5 (0.9%) leaks. Five hundred and forty-three laparoscopic right-sided resections were performed. There were 3 (0.6%) anastomotic leaks requiring reoperation and loop ileostomy. CONCLUSIONS: This step-by-step instructional video and procedural guide provides a simple and standardised approach which may be incorporated into a training pathway for laparoscopic right- and left-sided colorectal surgery.
Entities:
Keywords:
Colorectal surgery; Laparoscopic anterior resection; Laparoscopic colectomy; Laparoscopic ileocolic resection; Laparoscopic right hemicolectomy; Medial to lateral
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