Hand-assisted laparoscopic restaurative proctocolectomy : surgical technique and results in the therapy of Familial Adenomatous Polyposis and Ulcerative Colitis
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Data di Pubblicazione:
2007
Citazione:
Hand-assisted laparoscopic restaurative proctocolectomy : surgical technique
and results in the therapy of Familial Adenomatous Polyposis and Ulcerative Colitis [Moving Image] / E. Contessini Avesani, A. Carrara, F. Botti, C.M. Bagni, E. Gilardoni, B. Oreggia, C. Rocha. - Disco ottico. - [s.l], 2007.
Abstract:
This video shows the surgical laparoscopic technique used in our experience to perform total
colectomy and ileo-pouch-anal anastomosis (IPAA) for the therapy of Familial Adenomatous
Polyposis (FAP) and Ulcerative Colitis (UC). Surgical details are outlined, particularly regarding
laparoscopic hand-assisted total colectomy (HAL), proctectomy and rectal pathologic mucosa
complete removal with transanal mucosectomy, ileal reservoir preparing and ileo-pouch-anal
anastomosis manual suturing. Furthermore late endoscopic and functional controls of the ileal
reservoir are shown.
This video also reports our series and compared peri-operative parameters and outcomes achieved
with hand-assisted laparoscopic technique VS. open surgery (OS): we have reported data of 111
patients, from January 1996 to September 2006. Our results demonstrate that surgery timing was
similar in both techniques, once completed the short learning curve for hand-assisted laparoscopy.
Patients who underwent laparoscopic surgery needed significantly less analgesic therapy in the
post-operative phase, they had an earlier resumption of oral intake and an overall shorter
hospitalisation. Furthermore HAL patients had a shorter incision, less blood loss and less major
complications. There was no significant difference regarding minor complication. No patient
needed intra-operative conversion from laparoscopic approach to conventional open surgery and
mortality rate was 0%.
Conclusions: by means of this video the authors emphasize that Hand-assisted laparoscopic surgery
performing IPAA is safe and that it offers better therapeutic results than open surgery, in terms of
peri-operative parameters. Overall, in the surgical management of FAP and UC, this laparoscopic
approach allows to combine the convenience and safety of open surgery with the advantages of
traditionallaparoscopic surgery, maintaining the possibility of a radical treatment of the disease and
offering better aesthetic and functional results.
Tipologia IRIS:
11 - Applicazione o prodotto multimediale
Elenco autori:
E. Contessini Avesani, A. Carrara, F. Botti, C.M. Bagni, E. Gilardoni, B. Oreggia, C. Rocha
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