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 Cecal Wedge Resection Appendectomy
Ciro Andolfi, MD1; Marco Fisichella, MD, MBA, FACS2
1University of Chicago Pritzker School of Medicine
2VA Boston Healthcare System
This is the case of a 66-year-old man with a history of colon polyps, who undergoes colonoscopy every 3 years for surveillance. During the last colonoscopy, he was found to have a polyp at the appendiceal orifice. The biopsy showed the presence of adenoma.
Therefore, the patient underwent a laparoscopic appendectomy with wedge resection of the cecum. The operation went well and took less than an hour. The specimen was opened, and the adenoma was found within the lumen of the appendix, with at least 1.5 cm of clear margin. The patient was sent home the same day, and resumed regular diet and physical activities the following morning.
Laparoscopic Appendectomy
VA Boston Healthcare System
Marco Fisichella, MD, MBA, FACS
Assistant Professor of Surgery, Harvard Medical School
Associate Chief of Surgery, VA Boston Healthcare System
A 66-year-old man with a history of polyps has undergone colonoscopic surveillance every 3 years. After the recent discovery of an adenoma at the patient’s appendiceal orifice, Dr. Marco Fisichella performs a laparoscopic appendectomy.
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