Laparoscopic Surgery for Colorectal Cancer

243 Pages·2016·37.417 MB·English

by  Yoshiharu Sakai (eds.)

Laparoscopic Surgery
for Colorectal Cancer
Yoshiharu Sakai
Editor
123
Laparoscopic Surgery for Colorectal Cancer
ThiSisaFMBlankPage
Yoshiharu Sakai
Editor
Laparoscopic Surgery for
Colorectal Cancer
Editor
YoshiharuSakai
DepartmentofSurgery
KyotoUniversityGraduateSchoolofMedicine
Kyoto,Japan
ISBN978-4-431-55710-4 ISBN978-4-431-55711-1 (eBook)
DOI10.1007/978-4-431-55711-1
LibraryofCongressControlNumber:2016930401
SpringerTokyoHeidelbergNewYorkDordrechtLondon
#SpringerJapan2016
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Preface
Oncological safety as well as the minimum invasiveness of laparoscopic surgery
for colorectal cancer has been acknowledged worldwide, based on long-term
outcomes of several randomized controlled trials comparing laparoscopic
surgery and open surgery. Single port, reduced port, and robotic surgery have
also been developed following conventional laparoscopic surgery. Furthermore,
the laparoscopic approach has been applied to more advanced procedures, such
as intersphincteric resection, lateral pelvic node dissection, and trans-anal total
mesorectalexcision.
Why is laparoscopic surgery gaining popularity among surgeons even though
it consists of technically demanding procedures? One of the reasons is better
recognitionofsurgicalanatomyindetaileveninadeepandnarrowspace,thanks
to the development of optics. Modern technology has been demonstrating
finestructureswhichwehaveneverseeninopensurgeryorincadavericdissection.
In other words, we are fascinated with the beauty as well as the reality of
“lap-enhancedsurgicalanatomy”.
We have easy access to educational or instructive textbooks and beautiful
videos. Photos provide us a static process or anatomy, but it is often difficult to
understandthemwithoutthehelpofschema.Drawingsemphasizetheauthor’sidea
of surgical procedures or anatomy but are at risk of being misinterpreted or
misleading, as if an invisible structure were a visible one. Videos demonstrate
sequentialproceduresandfacilitatecomprehensionofstericanatomybutareoften
inadequate to build a shared image among surgeons. My concern is whether
historical technical terms such as “Denonvilliers’ fascia”, “Waldeyer’s fascia”,
“Gerota’s fascia”, and others that have been used in educational materials are
truly shared among surgeons or readers. The definitions of those technical terms
are still in debate [1]. Without sharing definitions or clear images, we would
misinterprettheproceduresorsurgicalanatomy.
Dissectionisoneofthebasicandimportantproceduresinoursurgery.Whatis
dissection?Isittorecognizethepre-existingmembranesandtoseparatethem?We
donotagreewiththat.Instead,webelievethatdissectionisdividingtheconnective
fibrous tissues or entering into the “dissectable layers”, resulting in making
membranesonbothsides.
v
vi Preface
Wehaveprovidedonlytherealityofeachstepofsurgicalprocedureswithsome
illustrationsandexcludedthehistoricaltechnicaltermsasmuchaspossibleinorder
to share the reality with you. We hope you enjoy the beautiful illustrations,
especially in Chap. 1 (Principles of Anatomy), and the reality expressed with
manyfinephotos.
Finally,wewouldliketoexpressourappreciationtoSpringer,ourpublisher,for
giving us such a great opportunity to demonstrate our basic idea for laparoscopic
colorectalsurgery.
Kyoto,Japan YoshiharuSakai
Reference
1. Kraima AC, West NP, Treanor D, Magee DR, Rutten HJ, Quirke P, et al. Whole mount
microscopic sections reveal that Denonvilliers’ fascia is one entity and adherent to the
mesorectal fascia; implications for the anterior plane in total mesorectal excision? Euro J
SurgOncol.2015;41:738–45.doi:10.1016/j.ejso.2015.03.224.
Contents
1 PrinciplesofAnatomy. . . . . . . .. . . . . . . .. . . . . . . . .. . . . . . . . .. 1
HisashiShinohara,SuguruHasegawa,ShigeruTsunoda,
HisahiroHosogi,andYoshiharuSakai
2 EvidenceofLaparoscopicSurgeryforColorectalCancer. . . . . . . 17
KoyaHida,RyosukeOkamura,TatsutoNishigori,NobuakiHoshino,
SaoriGoto,andKoichiOkumura
3 LaparoscopicRight-SidedColectomy(IleocecalResection,Right
Hemicolectomy,ExtendedRightHemicolectomy). . . . . . . . . . . . . . 31
JunichiroKawamura,KazukiUeda,HaruhikoImamoto,
andKiyotakaOkuno
4 LaparoscopicTransverseColectomy. .. . . . .. . . . .. . . . . .. . . . .. 53
KenjiKawada,GenNishikawa,HisashiShinohara,
andSuguruHasegawa
5 LaparoscopicLeft-SidedColectomy(MobilizationofSplenic
FlexureandSigmoidectomy). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 71
AkinariNomura,YasuoKoga,YukieYoda,andHirokazuNoshiro
6 LaparoscopicTotalMesorectalExcision(TME)
forRectalCancer. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 109
YoshiharuSakai,SuguruHasegawa,HisashiShinohara,
MasahiroYamada,andMichiakiOkada
7 LaparoscopicRightLateralPelvicLymphNodeDissection
(LPLND)withPelvicAutonomicNervePreservation. . . . . . . . . . . 137
SatoshiNagayama,MasashiUeno,andTakeshiSano
8 RestorativeProctocolectomy. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 155
RyoTakahashi,GenNishikawa,ShigeoHisamori,KenjiKawada,
HisashiShinohara,andYoshiharuSakai
vii
viii Contents
9 TransanalMinimallyInvasiveSurgeryforRectalCancer. . . . . . . 169
SuguruHasegawa,KoyaHida,KenjiKawada,andYoshiharuSakai
10 RoboticTotalMesorectalExcision. . . . . . . . . . . . . . . . . . . . . . . . . 197
AkinariNomura,YasuoKoga,YukieYoda,andHirokazuNoshiro
1
Principles of Anatomy
Hisashi Shinohara, Suguru Hasegawa, Shigeru Tsunoda,
Hisahiro Hosogi, and Yoshiharu Sakai
Abstract
This chapter describes the development of the gastrointestinal tract and
illustrates the important topographic anatomy with a focus on mesenteries.
During the early weeks of the embryo, the primitive gut tube is suspended
from the body wall by mesenteriesthat enclose the organ and connectit to the
body wall, providing pathways for vessels and lymphatics to and from the
abdominal viscera. With rotations of the stomach and the midgut loop, the
mesenteries undergo complex deformations, positional changes, and fusions to
adjacentorgans.Understandingtheseembryologicalprocesseswillbehelpfulin
recognition of anatomical pitfalls, and the application of such knowledge is
advantageousinlaparoscopiccolorectalsurgery.
Keywords
Anatomy (cid:129) Embryology (cid:129) Mesentery (cid:129) Gastrocolic trunk of Henle (cid:129) Midgut
rotation
1.1 Introduction
Anatomy is not just a classical form of medicine but is instead a science that
progresses with advances in surgery. In the past two decades, progress in
anatomical knowledge of the digestive system has been undoubtedly achieved
with the introduction of laparoscopic surgery. This is because the surgeon is now
able to inspect the surgical field using extremely high-resolution images and
magnificationonavideoscreenandallsurgicalteammemberscanshareacommon
H.Shinohara,M.D.(*)(cid:129)S.Hasegawa(cid:129)S.Tsunoda(cid:129)H.Hosogi(cid:129)Y.Sakai
DepartmentofSurgery,KyotoUniversityGraduateSchoolofMedicine,Sakyo-ku,Kyoto,Japan
e-mail:[email protected]
#SpringerJapan2016 1
Y.Sakai(ed.),LaparoscopicSurgeryforColorectalCancer,
DOI10.1007/978-4-431-55711-1_1