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Left Colectomy - LAR: Best Practices to Avoid Bleeding Complications
Colorectal Surgical Journeys
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2022
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Description
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One of the main surgical complications is operative bleeding. It is
often caused by injury to blood vessels, and severe hemorrhage
coming from major vascular structures. But it can also occur in wrong
dissection planes or layers during the procedure.
Anatomical knowledge and identifying anatomical landmarks remain
crucial factors in preventing operative bleeding. Effective exposure of
visual fields is a key strategy for preventing severe bleeding during
surgery.
The concept of Complete Mesocolic Excision comes with a more
meticulous D3 dissection, seeking apical lymph nodes with Central
vascular ligation (CVL). This technique is thought to have oncologic
advantages, but also a higher risk of vascular injuries. All the more
reason to have detailed vascular anatomical knowledge and a sound
surgical technique.
Understanding the tissue, device and technology interaction,
particularly an energy device, play key roles in operations. But even
though these devices are mainstays when performing a procedure
and also used to reduce blood loss, they can, however, also be the
cause of inadvertent injury if not properly handled.
Left colectomy with selective vascular preservation will be
demonstrated, giving some tips and tricks of oncologic principles and
on the identification of key structures and planes to carry out the
procedure.
PROGRAM
Welcome and Introduction - Dr. Marks (USA) and Dr. Cajucom (Philippines)
Surgical procedure discussion US perspective - Dr. Marks (USA) and Dr. Cajucom (Philippines)
Surgical procedure discussion Philippines perspective - Dr. Cajucom (Philippines) and Dr. Marks (USA)
Closing Remarks - Dr. Marks (USA) and Dr. Cajucom (Philippines)