Susana Ouro, Ian Jenkins, Robin Kennedy
This DVD demonstrates the technique of laparoscopic high anterior resection. The laparoscopic approach is rapidly becoming the standard procedure for segmental colectomy and there is increasing demand for surgeons who are skilled in this area.
Laparoscopic colorectal surgery has increased exponentially in the UK over the last 5 years and has benefits to both the patient and the institution. When combined with an enhanced recovery programme, significant reduction in length of stay can be achieved, coupled with an early return to normal activity for the patient. The DVD sets out a safe and reproducible technique for laparoscopic high anterior resection and is meant as a useful adjunct to “hands-on” training, allowing the surgeon to review the procedure in his or her own time.
The standardisation of Total Mesorectal Excision or TME as it has become known, has improved outcomes following rectal cancer surgery, mainly due to the reduction in local recurrence. The concept of TME can also be applied in the colon as Complete Mesocolic Excision. Complete mesocolic excision is the sharp dissection of the visceral mesocolic fascial layer from the retroperitoneal parietal layer. This allows one to resect an intact lymphovascular package, minimising tumour cell spillage and potentially improving outcome.
Well-performed, laparoscopic colonic surgery improves recovery by reducing complications and hospital stay. We hope that using this approach to laparoscopic surgery as described in this video will permit reproducible, high quality, Total Mesocolic Excision. This will benefit our patients, also improving their cancer outcomes.