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Workshop on colorectal surgical procedures

Workshop on colorectal surgical procedures. Division of Colorectal Surgery The Chinese University of Hong Kong. Intensive Surgery Course for Medical Year 5 (2006/2007). Objectives. To appreciate the surgical anatomy related to colorectal surgical procedures

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Workshop on colorectal surgical procedures

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  1. Workshop on colorectal surgical procedures Division of Colorectal Surgery The Chinese University of Hong Kong Intensive Surgery Course for Medical Year 5 (2006/2007)

  2. Objectives • To appreciate the surgical anatomy related to colorectal surgical procedures • To understand the indications, nature, and complications of various common colorectal surgical procedures

  3. Methods • 4 groups : 1 (39-49), 2 (50-59), 3 (60-69), 4 (70-79) • Each group will be assigned a topic with a list of questions to answer • Literature search in the library for 10 minutes • Each group will have 12 minutes for presentation + questions from the floor and the tutor

  4. Right hemicolectomy

  5. Right hemicolectomy • Describe the arterial blood supply of the colorectum. • What is meant by right hemicolectomy? What should be the extent of resection? • What is the difference between right hemicolectomy and extended right hemicolectomy? • What is the ‘White line of Toldt’? • What are the anatomical structures that may be damaged during a right hemicolectomy? • What is meant by ‘en bloc’ resection? What are the structures that may be resected ‘en bloc’ during a right hemicolectomy? • What are the indications for right hemicolectomy? • The anastomosis after right hemicolectomy is an ileocolic anastomosis which is usually thought to be safe. However, under what circumstances would you not consider a primary anastomosis after right hemicolectomy? • What are the complications of right hemicolectomy?

  6. Anterior resection

  7. Anterior resection • Where is the rectosigmoid junction anatomically and surgically? • Who is Claude Dixon? • What is meant by anterior resection? • Is there a procedure known as ‘posterior’ resection? • What is the difference between anterior resection and low anterior resection? • What are the anatomical structures that may be damaged during anterior resection? • What are the complications of anterior resection? • Concerning anastomotic leakage after anterior resection: • How do they present clinically? • What are the risk factors? • How would you manage such a complication?

  8. Hartmann’s operation

  9. Hartmann’s operation • Who is Hartmann? • What is meant by Hartmann’s operation? • What are the indications for Hartmann’s operation? • What is the difference between Hartmann’s operation and abdominoperineal resection? • What are the complications of Hartmann’s operation? • What are the complications that can arise from the colostomy? • In the management of patients with malignant left-sided large bowel obstruction, Hartmann’s operation is regarded to be a ‘two-stage’ operation. What are the two stages? What are the other treatment options?

  10. Laparoscopic colorectal surgery

  11. Laparoscopic colorectal surgery • When and where was the first laparoscopic colorectal resection done? And by whom? • Who performed the first laparoscopic colorectal surgery in Hong Kong? • What are the indications and contraindications for laparoscopic colorectal surgery? • What are the disadvantages of laparoscopic colorectal surgery? • What is the rate of conversion? What are the reasons for conversion? • What are the complications of laparoscopic colorectal surgery? • What is meant by port site metastasis (PSM)? How common is this problem? What are the possible mechanisms that can lead to PSM? • ‘Laparoscopic surgery is oncologically as safe as open surgery in managing patients with colorectal cancer.’ Is this statement correct? Is there any evidence in the world literature?

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