Wednesday, April 14, 2010

Laparoscopic TME

Classicc trial. Validation ongoing
Guilou lancet 2005

Main reason for conversion is tumor fixation.
- emphasizes importance of MRI in preoperstive evaluation.

Unfortunately classicc trial didn't demonstste short or long tern quality of life or sexual function. Marginal shorter LOS.
Main advantage is 2% hernia rate.

Classicc trial has shown feasibilty.
Ongoing trials needed to confirm efficacy.
40% of patients in France with rectal cancer are operated laparoscopicakky. Panel agreed would not choose to randomize vs open.

Technique. Strasbourg France
3 dimensional retraction principles- heald
- gauze retractor to achieve this
- articulating instrumnts?
- bipolar vs scissors with monopolar cautery

Option for hybrid lap surgery to take down splenic flexure.
- Posted from iPhone



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