Laparoscopic Colectomy: A Step by Step Guide

195 Pages·2020·17.045 MB·English

by  Sharon L. Stein, Regan R. Lawson

Matthew P. Lungren
Michael R.B. Evans
Editors
Clinical Medicine
Laparoscopic
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Laparoscopic Colectomy
Sharon L. Stein • Regan R. Lawson
Editors
Laparoscopic Colectomy
A Step by Step Guide
Editors
Sharon L. Stein Regan R. Lawson
University Hospital Cleveland Exponent
Medical Center Philadelphia, PA
Cleveland, OH USA
USA
ISBN 978-3-030-39557-5 ISBN 978-3-030-39559-9 (eBook)
https://doi.org/10.1007/978-3-030-39559-9
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Preface
Minimally invasive surgery has become a standard approach to surgical prob-
lems including colon and rectal surgery. While minimally invasive surgery
provides significant benefits to the patient, appreciating the challenges of
anatomy from a laparoscopic perspective has created new challenges for both
educators and trainees. This book was designed specifically to help equip new
surgeons with the anatomical and technical knowledge to supplement hands-
on experience in minimally invasive colon and rectal surgery.
There are multiple colorectal surgeries which distinctly lend themselves to
the use of the laparoscopic approach. To assist the junior surgeon who is
embarking on a career in surgery, we enlisted the help of expert surgeons and
educators in the field of colon and rectal surgery from around the country to
author the chapters included in this book. Our goal was to impart the mastery
of these experts to help the junior surgeon optimize minimally invasive
surgery.
We asked our authors to describe key elements of each surgery, including
the order of surgery and when and how they created tension, rotated the
patient, and optimized flow of the surgery. We turned to the adage “Skill
comes from experience, but not all that experience needs to be yours.” In
addition to the key elements of each surgery, the authors have provided the
reader with tips and pitfalls to guide and warn the junior surgeon. These tips
and pitfalls are the “trade secrets” that are not always explicitly presented
when describing a surgical approach as they tend to be situational, not occur-
ring in every surgery. It is our hope that the addition of such information,
presented in separate text boxes, will arm junior surgeons with a diverse tool-
kit in which to draw upon. Each chapter is also full of new illustrations to
show the direction of traction, the line of dissection, and the anatomy of the
colon and presents tools in a color-coded format to clearly distinguish
between the surgeon and the assistant’s tools.
We hope that this book will be one that residents and junior attendings turn
to often when mastering laparoscopic colon and rectal surgery – a book that
conveys the experience of our talented authors and surgeons, as if they were
in the room with you, guiding you through the surgery.
Cleveland, OH, USA Sharon L. Stein
Philadelphia, PA, USA Regan R. Lawson
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Acknowledgments
This book was an enormous effort and we would like to thank our authors for
their time, experience, and expertise. It is not an easy task to translate the
actions they engage in during their surgeries into text descriptions, and they
have done tremendous and thoughtful work in presenting their approaches in
a very accessible manner. We would also like to thank the illustrators who
worked with us through multiple revisions in our attempt to provide you with
the most informative representation of each surgery. We would like to thank
our families and friends who supported us through this project, the challenges
and triumphs. And we would like to thank each other for adding perspective
and richness to this text and for the synergy that always seems to happen
when we get together.
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Contents
1 Tools . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
Kurt G. Davis and Lisa Coviello
2 Laparoscopic Right Colectomy . . . . . . . . . . . . . . . . . . . . . . . . . . . 15
Raul M. Bosio and Sharon L. Stein
3 Laparoscopic Transverse Colectomy . . . . . . . . . . . . . . . . . . . . . . . 35
Govind Nandakumar and Tushar Samdani
4 Splenic Flexure . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 49
Kevin R. Kniery, Michael J. Mulcahy, and Scott R. Steele
5 Laparoscopic Sigmoid/Left Colectomy . . . . . . . . . . . . . . . . . . . . . 65
Todd D. Francone and Ron G. Landmann
6 Laparoscopic Proctectomy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 85
Jason S. Mizell
7 Abdominal Perineal Resection . . . . . . . . . . . . . . . . . . . . . . . . . . . . 107
Bradley J. Champagne and Mark L. Manwaring
8 Subtotal Colectomy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 125
Joshua I. S. Bleier and Skandan Shanmugan
9 Laparoscopic Proctocolectomy with the Construction
of an Ileal Pouch-Anal Anastomosis . . . . . . . . . . . . . . . . . . . . . . . 141
David B. Stewart
10 Laparoscopic Lysis of Adhesions and Bowel Obstruction . . . . . . 159
Meagan M. Costedio and Anthony L. DeRoss
11 Complications . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 171
Justin A. Maykel and Andrew T. Schlussel
Index . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 187
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Contributors
Joshua I. S. Bleier Department of Surgery, Division of Colon & Rectal
Surgery, Perelman School of Medicine, Pennsylvania Hospital, Philadelphia,
PA, USA
Raul M. Bosio Division of Surgery, ProMedica Health & Wellness Center,
Sylvania, OH, USA
Bradley J. Champagne Department of Surgery, Cleveland Clinic Fairview
Hospital, Cleveland, OH, USA
Meagan M. Costedio Division of Colorectal Surgery, University Hospitals,
Cleveland, OH, USA
Lisa Coviello Center for Colorectal Surgery, Tidewater Physicians Multi-
specialty Group, Newport News, VA, USA
Kurt G. Davis Section of Colon and Rectal Surgery, LSUHSC, LA, USA
Anthony L. DeRoss Pediatric Surgery, Cleveland Clinic, Cleveland, OH,
USA
Todd D. Francone Division of Colon & Rectal Surgery at Newton-Wellesley
Hospital, Newton, MA, USA
Kevin R. Kniery Department of Surgery, Madigan Army Medical Center,
Tacoma, WA, USA
Ron G. Landmann MD Anderson Cancer Center - Baptist Medical Center,
Jacksonville, FL, USA
Colon and Rectal Surgery, Mayo Clinic, Jacksonville, FL, USA
Mark L. Manwaring Saint Thomas Medical Partners in Murfreesboro,
Greenville, TN, USA
Justin A. Maykel Department of Colon and Rectal Surgery, University
of Massachusetts Medical School, Worcester, MA, USA
Jason S. Mizell University of Arkansas for Medical Sciences, Division
of Colon and Rectal Surgery, Little Rock, AR, USA
Michael J. Mulcahy Tripler Army Medical Center, Honolulu, HI, USA
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xii Contributors
Govind  Nandakumar Department of Surgery, Weill Cornell Medical
College New York, New York, NY, USA
Tushar Samdani Department of Surgery, Medstar Saint Mary’s Hospital,
Leonardtown, MD, USA
Andrew T. Schlussel Division of Surgery, Madigan Army Medical Center,
Tacoma, WA, USA
Skandan Shanmugan Department of Surgery, Division of Colon & Rectal
Surgery, Penn Presbyterian Medical Center, Philadelphia, PA, USA
Scott  R.  Steele Department of Colorectal Surgery, Digestive Disease
and Surgery Institute, Cleveland Clinic, Cleveland, OH, USA
Sharon L. Stein Division of Colon and Rectal Surgery, Department of
Surgery, University Hospital Cleveland Medical Center, Cleveland, OH,
USA
David B. Stewart Colorectal Surgery, University of Arizona – Banner
University Medical Center, Tucson, AZ, USA
About the Editors
Content Editor and Contributing Author
Sharon L. Stein, M.D., is a board certified colon and rectal and general

surgeon. She is Associate Professor of Surgery and the Murdough Master
Clinician of Colon and Rectal Surgery at the University Hospital Cleveland
Medical Center, Cleveland, Ohio. She serves as the Director of UH Research
in Surgical Outcomes and Effectiveness (UH-RISES) and the Program
Director of the Colon and Rectal Surgery Residency at university hospitals in
Cleveland, OH. Dr. Stein has published over 100 articles, abstracts, and book
chapters and is frequently invited to speak nationally and internationally
about minimally invasive surgery. She is an active leader in multiple surgical
societies including the American Society of Colon and Rectal Surgeons
(ASCRS), American College of Surgeons, and Society of American
Gastrointestinal and Endoscopic Surgeons and is the current President of the
Association of Women Surgeons.
Educational Editor
Regan R. Lawson, Ph.D., has a doctorate in Applied Physiology with a

focus on cognitive motor control and motor learning and Master of Arts in
Secondary Science Education. She has spent over 25 years in the educational
field working with students of all ranges including undergraduate and gradu-
ate neuroscience students. Her publications have focused on the motor learn-
ing during prosthetic use. She has been invited to provide multiple lectures
and presentations for neuroscience, science education, curriculum develop-
ment, and teacher training. Regardless of the learner, her focus is on present-
ing information in formats which capitalize on educational pedagogy and
neuroscientific learning principles. She is an active member of the Society for
Neuroscience and the Human Factors and Ergonomics Society. Dr. Lawson
currently works at Exponent as a Human Factors Scientist providing consult-
ing services in a variety of areas including those associated with improving
how users learn to effectively and safely use a product.
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