Laparoscopic-Assisted Right Hemicolectomy
Anthony D. Douglas II, MD; Derrius Anderson, MD; Jelani Williams, MD; Rowan Hussein; Ashley Russell; Konstantin Umanskiy, MD
UChicago Medicine
The patient-centered environment of the operating room often precludes extensive intraoperative discussions or detailed explanations between a resident and the attending surgeon. This constraint in real-time feedback poses a challenge for surgical residents to refine their surgical skills. Implementation of a structured case review between attendings and senior residents at interval timepoints of their rotations could support addressing this gap. This case presents a laparoscopic right hemicolectomy. This procedure removes a portion of the colon and is commonly indicated for colon cancer. In this video article, a senior general surgery resident participates in the procedure and then engages in a structured case review with their attending, analyzing the fundamental steps of the procedure as well as identifying opportunities for technical improvement and enhancement of intraoperative decision-making.
Laparoscopic Right Colectomy with Ileocolic Anastomosis
Joshua M. Harkins1; David Rattner, MD2
1Lake Erie College of Osteopathic Medicine
2Massachusetts General Hospital
Colonic polyps are projections from the surface of the colonic mucosa. Most are asymptomatic and benign. Over time, some colonic polyps develop into cancers.
Carcinoid tumors develop from cells in the submucosa. They are slow-growing neoplasms. Carcinoid tumors of the colon are rare, comprising less than 11% of all carcinoid tumors and only 1% of colonic neoplasms. The majority of patients diagnosed with carcinoid tumors have no symptoms, and their tumors are found incidentally during endoscopy.
This is the case of a middle-aged male who had an unresectable polyp in the ascending colon and a carcinoid tumor in the ileocecal valve. The patient underwent laparoscopic right colectomy with ileocolic anastomosis to remove both lesions.
Laparoscopic Total Abdominal Colectomy with Ileorectal Anastomosis for Crohn’s Colitis and Multifocal Dysplasia
Winta T. Mehtsun, MD, MPH; Richard Hodin, MD
Massachusetts General Hospital
Crohn’s disease is a type of inflammatory bowel disease that can chronically affect the entire gastrointestinal tract, with a propensity for the distal ileum. It causes transmural inflammation of the intestines, where it can cause abdominal pain, severe diarrhea, fatigue, weight loss, and malnutrition.
There is no cure for Crohn’s disease; the goal of treatment is to palliate symptoms, accomplished with both medical and surgical options. Surgery is generally reserved for patients who are unresponsive to aggressive medical therapy or those who develop complications.
Here, we present the case of a 59-year-old male with chronic gastrointestinal problems thought to be Crohn’s colitis. Colonoscopy with biopsy of multiple areas showed dysplasia, prompting surgical resection. In this case, the entire colon was affected with rectal sparing; therefore, a total abdominal colectomy with ileorectal anastomosis was performed.
Robotic Right Hemicolectomy for Tubulovillous Adenoma with High-Grade Dysplasia: Multimedia Analysis of a Contemporary Technique
Christopher L. Kalmar, MD; Caleb L. Cutherell, MD; Farrell C. Adkins, MD
Virginia Tech Carilion
Robotic right hemicolectomy is a minimally invasive technique for right colon resections. The technique utilizes a robotic laparoscopic instrument to perform dissection of the right colon and to perform intracorporeal anastomoses, allowing for smaller abdominal incisions, quicker recovery times, and decreased short- and long-term complications.
In this case, a robotic right hemicolectomy was performed to remove an endoscopically unresectable mass at the ileocecal valve. An intracorporeal-stapled ileocolic anastomosis was performed, and the colon was removed through a trocar insertion site. The robotic-assisted minimally invasive technique allows for clear visualization of the dissection planes and facilitates intracorporeal anastomoses that would otherwise be difficult to perform using traditional laparoscopy.
Robotic Right Hemicolectomy
Virginia Tech Carilion
Farrell C. Adkins, MD
Colon and Rectal Surgery
Christopher L. Kalmar, MD
Resident Physician
Caleb L. Cutherell, MD
Resident Physician
In this case, a robotic right hemicolectomy is performed and narrated by Dr. Farrell Adkins at Virginia Tech Carilion.
Laparoscopic Total Abdominal Colectomy with Ileorectal Anastomosis
Massachusetts General Hospital
Richard Hodin, MD
Professor of Surgery
Harvard Medical School
A 59-year-old male with a history of Crohn’s disease underwent a colonoscopy where several areas of multifocal dysplasia were discovered. In this case, Dr. Richard Hodin performs a total abdominal colectomy on this patient in order to remove these precancerous lesions and prevent recurrence.
Laparoscopic Right Colectomy
David Rattner MD
Massachusetts General Hospital
Dr. Rattner performs a laparoscopic right colectomy to treat an unresectable polyp and incidental carcinoid tumor.
Open Total Colectomy
David Berger, MD
Associate Professor of Surgery, Massachusetts General Hospital
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