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General Surgery
Large Intestine and Anorectum Surgery of the Anorectum
Built from Skandalakis' Surgical Anatomy: The Embryologic and Anatomic Basis of Modern Surgery
What’s inside
6 sections · 95 slides
Overview
- Scope of this topic
Anatomic guidelines for anorectal examination
- Surgical principles in cloacal exstrophy
- Mandatory examination before any anorectal procedure
- Anorectal landmarks for sigmoidoscopic examination
- The anal verge as reference line
- Digital examination at the distal interphalangeal joint
- Digital examination at the middle interphalangeal joint
- Digital examination at the metacarpophalangeal joint
- Three depths of digital examination
- Sigmoidoscopic technique and depth landmarks
- Depths from the anal verge
- Passage of the sigmoidoscope
- Flexures of the rectum
- Site of greatest perforation risk at sigmoidoscopy
- Colonic anatomy in Western versus Oriental patients
- Total colonic length is not the explanation
Benign anorectal conditions
- Origin of anorectal fistulas
- Fistulectomy versus fistulotomy
- Operative rules in fistula surgery
- Drainage of anorectal abscesses
- Anal fissure: definition and aetiology
- Treatment of anal fissure
- Continence after sphincterotomy and dilatation
- Exclusion before anal dilatation
- Pilonidal disease
- Haemorrhoids: classification and requirement
- Rectal prolapse: definition
- Normal pelvis before prolapse
- Onset of intussusception
- Intussusceptum reaching the pectinate line
- Complete prolapse through the anus
- Sequence of prolapse development
- Outcomes of surgery for rectal prolapse
Anorectal cancer surgery
- Four anatomic layers of the posterior visceral compartment
- Circumstances that select the plane of dissection
- Further indications for the lateral pelvic planes
- Sphincter preservation and oncologic outcome
- Restoration of intestinal continuity after proctectomy
- Neosphincter options in end-stage incontinence
- Adjuvant therapy after local excision and sphincter shielding
- Sentinel lymph node mapping in colorectal cancer
Anatomic complications of the colon
- Leakage in 1,703 colonic anastomoses
- Mortality after anastomotic leakage by site
- Factors increasing anastomotic dehiscence
- Ideal versus unfavourable operative circumstances
- Measures that reduce but do not eliminate leakage
- Omentoplasty and stapled technique
- Blood supply and colorectal anastomotic leakage
- Magnetic compression anastomosis
- Single longitudinal slit widening a bowel end
- Two bowel ends of unequal calibre with stay sutures
- Other anastomotic complications
- Vascular injury during colonic surgery
- Incidence of ureteric injury in rectal excision
- Avoiding injury to the left ureter
- Management of the injured ureter
- Solid organ injury during colectomy
- Injury to pelvic viscera in low resections
- Autonomic nerve preservation in rectal cancer surgery
- Preoperative versus postoperative sexual dysfunction
- Evidence of an inadequate procedure
- Complications of cecostomy and colostomy
- Consequences of a stoma aperture that is too tight or too loose
- Blood supply and retraction of a colostomy
- Complications of colostomy closure
- Emergency colonic stoma formation
- Parastomal herniation
- Complications of abdominoperineal resection
- Vascular and organ injury in abdominoperineal resection
- Nerve injury and the fascia of Waldeyer
- Operative sequence and rectal perforation in APR
- Iatrogenic perforation from barium enema or colonoscopy
Anatomic complications of the anorectum
- Complications after fistula surgery
- Major complications of rectal surgery
- Continence after treatment of abscess and fistula
- Anal stenosis and stricture after haemorrhoidectomy
- Treatment of established anal stenosis
- Incidental carcinoma in haemorrhoidectomy specimens
- Complications after prolapse and anorectal cancer surgery
- Sphincter defects after transanal stapling
- Key numbers to carry away
- Operative principles to carry away
- References
- References (continued)
- References (continued)
- References (continued)
- References (continued)
- References (continued)
- Skandalakis' Surgical Anatomy: The Embryologic and Anatomic Basis of Modern Surgery
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