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Файл:Ординатура / Хирургия / Библиотека им академика М.И. Перельмана / Книга_841_Библиотеки_им_академика_М_И_Перельмана.pdf
X
- •Contents
- •Contributors
- •The Basics
- •1: Introduction
- •Reference
- •2.1 Introduction
- •2.7 Discussion
- •References
- •3.2 Legal Framework
- •3.6 Enlightenment
- •3.7 Documentation
- •3.8 Conclusion
- •3.1 Introduction
- •References
- •Further Reading
- •5: Introduction
- •5.1.1 Approach
- •Reference
- •6.1 Introduction
- •6.2.3 Crural Repair
- •7.1 Introduction
- •7.2.1 Access
- •7.2.2 Dissection
- •7.2.4 Fundoplication
- •Paraesophageal Hernia/Upside-Down Stomach
- •8.1 Introduction
- •8.2 Preparation
- •8.3 Operative Technique
- •8.5 Hiatoplasty
- •8.6 Fundoplication
- •8.7 Summary
- •9.1 Introduction
- •9.2 Preoperative Workup
- •9.3 Preparation
- •9.4 Surgical Technique
- •9.4.1 Reduction of Hernia Sac
- •9.4.2 Mediastinal Dissection
- •9.4.3 Crural Closure
- •9.5.1 Short Esophagus
- •9.5.3 Bleeding
- •9.5.4 Visceral Injury
- •References
- •10.1 Background
- •10.2 Evaluation
- •10.3 Procedure
- •10.4 Post-op Regimen
- •10.5 Complications
- •10.6 Follow-Up
- •11.1.1 Preoperative Workup
- •11.1.2 Operating Room Setup
- •11.1.3 Operative Technique
- •11.1.4 Fundoplication Construction
- •11.2.1 Abnormal Vascular Anatomy
- •11.2.2 Adipose Tissue
- •11.2.3 Adhesions
- •11.2.4 “Small Gastric” Fundus
- •11.2.5 Intrathoracic Stomach
- •11.3 Personal Experiences
- •References
- •12.1 Introduction
- •12.2 Technique
- •12.2.2 S-Nissen Fundoplication
- •12.2.3 S-Gastric Resection
- •12.2.4 S-Gastric Ulcer Repair
- •12.3 Discussion
- •References
- •13.1 Introduction
- •13.2 Preoperative Assessment
- •13.3 Operative Technique
- •13.4 Special/Unusual Situations
- •13.5 Postoperative Course
- •References
- •Individual Surgery for Gastric Gastrointestinal Stromal Tumors
- •14: Introduction
- •14.3 Distal Gastrectomy
- •14.5 Multivisceral Resection
- •15.1 Introduction
- •15.4 Postoperative Problems
- •References
- •16.1 Introduction
- •16.2 Prognostic Factors
- •16.3 Preoperative Considerations
- •16.3.1 Presentation
- •16.3.4 Neoadjuvant Therapy
- •16.4 Surgical Technique
- •16.4.2 Laparoscopic Approach
- •Patient Selection
- •Preparation
- •Technique
- •16.4.3 Open Approach
- •Patient Selection
- •Preparation
- •Technique
- •16.5 Intraoperative Complications
- •16.5.1 Pneumothorax
- •16.6.2 Reoperative Gastric Surgery
- •References
- •Further Reading
- •Individual Surgery for Gastric Cancer
- •17: Introduction
- •17.1 Approach
- •18.2 Remnant Gastrectomy
- •18.3 Conclusion
- •References
- •19.1 Introduction
- •19.1.2 Therapeutic Strategies
- •19.1.3 Extent of Resection
- •19.2 Preparation
- •19.3 Surgical Technique
- •19.3.3 Subtotal Gastric Resection
- •20.1 Introduction
- •20.3 Operative Technique
- •20.3.1 Resection
- •20.3.2 Reconstruction
- •20.3.4 Subtotal Distal Gastrectomy
- •Literature
- •21.1 Introduction
- •21.3 Subtotal Gastrectomy
- •References
- •Individual Surgery for Benign Gallbladder and Bile Ducts Diseases
- •22: Introduction
- •22.1 Patients with Symptomatic Cholecystolithiasis
- •22.2 Patients with Acute Cholecystitis
- •23.5 Abnormal Anatomy
- •23.6 Variants
- •23.6.3 Accessory Bile Ducts (II-III)
- •23.7 Pathological Anatomy
- •23.7.2 Mirizzi Syndrome (III-IV)
- •23.8 Extrahepatic Bile Duct Injuries
- •23.9 Common Bile Duct Stones
- •Reference
- •24.2.1 Introduction
- •24.2.2 Surgical Technique
- •24.2.3 Indications
- •24.2.4 Results
- •References
- •25.1 Introduction
- •25.3 Laparoscopic Technique
- •25.3.1 Positioning
- •25.3.2 Trocar Placement
- •25.3.6 Right Hemicolectomy
- •25.4 Conclusions
- •References
- •26.1 Introduction
- •26.3 Duodenal Fistula
- •26.4 Sigmoid and Rectal Fistulae
- •26.5 Stricturing Disease
- •26.6 Conclusion
- •References
- •27.1 Crohn’s Disease
- •27.1.4 Abdominal Fistulae
- •Ulcerative Colitis
- •Anal Canal-Sustaining Colectomy
- •The Pouch Design
- •Pouch Redo Surgery
- •27.3 Conclusions
- •References
- •Further Reading
- •Individual Surgery for Right Hemicolectomy
- •28: Introduction
- •28.1.1 Approach
- •28.1.2 Exploration
- •28.1.3 Right Colon Mobilisation
- •28.1.4 Transection of Vessels
- •28.2.1 Trocar Placement
- •28.2.2 Transection of Vessels
- •28.2.3 Right Colon Mobilisation
- •28.2.5 Removing of Specimen
- •29.1 Introduction
- •29.2 Operating Room
- •29.3 Surgical Technique
- •29.5 Conclusions
- •References
- •30.1 Introduction
- •30.2 Preparation
- •30.3 Technique
- •30.4 Intraoperative Complications
- •30.6 Conclusion
- •References
- •31.1 Introduction
- •31.2 Preparation
- •31.3 Surgical Technique
- •References
- •32.1 Introduction
- •32.2 Patient Preparation
- •32.3 Operation Technique
- •32.4 Reconstruction Phase
- •Individual Surgery for Left Hemicolectomy
- •33: Introduction
- •34.1 Introduction
- •34.2 Preparation
- •34.3 Surgical Technique
- •34.4 Postoperative Management
- •34.5.1 Splenic Injury
- •34.5.2 Ureteral Injury
- •Other Colon Tumors
- •PeritoneaI Carcinomatosis
- •Liver Metastases
- •Liver Cirrhosis, Portal Hypertension
- •References
- •35.1 Introduction
- •35.2.1 Concept
- •35.2.5 Anastomosis
- •35.3.1 Concept
- •35.3.2 Set-Up
- •35.3.6 Anastomosis
- •36.1 Preparation
- •36.2 Operation Technique
- •Individual Surgery for Sigmoid Diverticulitis
- •Reference
- •38.2 Tactics of the Operation
- •38.3 Loop Ileostomy
- •38.4 Hartmann’s Procedure
- •38.6 Loop Ileostomy
- •38.7 Hartmann’s Procedure
- •38.9 Open Loop Ileostomy
- •38.10 Open Hartmann’s Procedure
- •Individual Surgery for Rectal Cancer
- •39: Introduction
- •39.1.1 Approach
- •Step 5: Rectal Transection
- •Step 6: Anastomosis
- •39.3 Rectum Extirpation
- •40.1 Introduction
- •40.2 Preparations
- •40.3 Surgical Technique
- •42.1 Introduction
- •42.1.2 Insertion of the Trocars
- •42.2 Operation Technique
- •42.2.2 Protective Ileostomy
- •42.3 Discussion and Conclusion
- •42.4.1 Situation
- •42.4.2 Solution of the Problem
- •42.4.3 Analysis
- •42.4.4 Conclusion
- •43.1 Introduction
- •43.2 Surgical Technique
- •43.2.2 Anterior Rectal Resection
- •43.2.3 Low Anterior Resection
- •44.2 The Surgery
- •44.2.1 High Anterior Resection (HAR)
- •44.2.2 Low Anterior Resection (LAR)
- •44.3 Locally Advanced Tumours
- •44.4 When to Convert
- •44.5 Tips
- •44.5.1 Patient Positioning
- •44.5.2 Port Placement
- •44.5.4 Technical Tips
- •44.5.5 The Adipose Patient
- •44.6 Quality Control
- •44.7 Pitfalls
- •44.7.2 Small Bowel Injury
- •44.7.3 Injury to the Ureter
- •44.7.4 Nerve Injury
- •44.7.5 Colon/Rectum Injury
- •44.7.6 Injury to the Vagina
- •Reference
- •Further Reading
- •45.1 Introduction
- •45.3 Preparation
- •45.3.1 Procedure, Abdominal Part
- •45.3.2 Procedure, Perineal Part
- •References
- •46.1 Introduction
- •46.3 Initial Workup
- •46.4 Patient Preparation
- •46.5 Patient Positioning
- •46.6 Equipment
- •46.7 Operative Technique
- •46.7.1 Port Placement
- •46.7.2 Colonic Mobilisation
- •Exposure
- •Isolation and Ligation of the Vascular Pedicle
- •Medial to Lateral Mobilisation and Ligation and Division of the Inferior Mesenteric Vein
- •Lateral Mobilisation
- •Mobilisation of the Left-Sided Transverse Colon
- •Step 1: Posterior Dissection
- •Step 2: Right Lateral Dissection
- •Step 3: Anterior Dissection (Exposure)
- •Step 4: Left Lateral Dissection
- •Step 5a: Anterior Dissection in Male
- •Step 5b: Anterior Dissection in Female
- •Step 6: Right and Left Posterolateral Dissection, Exposure of Erigent Pillars
- •Step 7: Completion of Dissection
- •Step 8: Rectal Washout
- •Step 9: Stapler Division
- •46.7.4 Extraction of Specimen
- •46.7.5 Anastomosis
- •46.7.6 Loop Ileostomy
- •46.8 Postoperative Care
- •46.9 Conclusion
- •References
- •47.1 Introduction
- •47.2.1 Preoperative Evaluation
- •47.2.2 Preoperative Radiotherapy
- •47.2.3 Preparation
- •47.2.5 Surgical Procedure
- •First Stage: Abdominal Phase
- •Second Stage
- •47.4.1 Bleeding
- •Further Reading
- •References
- •50: Pelvic Autonomic Nerve Preservation during Total Mesorectal Excision (TME) from Werner Kneist
- •50.1 Introduction
- •50.2 Preoperative Aspects
- •50.2.1 Medical History
- •50.2.2 Clinical Examination
- •50.2.3 Imaging Diagnostics
- •50.3 Surgery Technique
- •Pelvic Neuroanatomy
- •Inferior Mesenteric Plexus
- •Hypogastric Nerves and Superior Hypogastric Plexus
- •Inferior Hypogastric Plexus, Pelvic Splanchnic Nerves
- •Nn. Rectales Inferiores
- •50.5 Postoperative Aspects
- •50.6 Case Examples
- •References
- •Individual Surgery for Rectal Prolapse
- •51: Introduction
- •52.1 Introduction
- •52.2 The Concept of NOTES
- •52.3 Patient Preparation
- •52.4 Operative Technique
- •53.1 Introduction
- •53.2 Technique
- •53.2.1 Patient Selection
- •53.2.2 Preparation
- •53.2.3 Operative Technique
- •53.2.4 Postoperative Care
- •References
- •54.1 Stapled Hemorrhoidopexy
- •Ideal Case
- •Not Quite Ideal Cases
- •Problematic Cases
- •Very Problematic Case
- •54.2 STARR
- •Ideal Cases
- •Not Quite Ideal Cases
- •Problematic Cases
- •Very Problematic Cases
- •Technique by Two Staplers
- •Very Problematic Case
- •Technique by Contour Transtar
- •54.4 SIR Procedure
- •54.5 POPS Technique
- •54.5.1 Very Problematic Case
- •Index

Gastrointestinal
Operations and
Technical Variations
Michael Korenkov
Christoph-Thomas Germer
Hauke Lang
Editors
123

Gastrointestinal Operations and Technical Variations

Michael Korenkov
Christoph-Thomas Germer
Hauke Lang
Editors
Gastrointestinal
Operations and
Technical
Variations

Editors
Michael Korenkov
General and Visceral Surgery
Klinikum Werra-Meissner
Teaching Hospital Eschwege
University of Goettingen
Eschwege, Germany
Christoph-Thomas Germer
Department of General, Visceral, Vascular
and Pediatric Surgery, University Hospital
Julius-Maximilians-University
University of Wuerzburg
Wuerzburg, Germany
Hauke Lang
Department of General,
Visceral and Transplant Surgery
University Medicine of the Johannes
Gutenberg-University Mainz
Mainz, Germany
ISBN 978-3-662-49876-7 ISBN 978-3-662-49878-1 (eBook)
DOI 10.1007/978-3-662-49878-1
Library of Congress Control Number: 2017945924
© Springer-Verlag Berlin Heidelberg 2017
This work is subject to copyright. All rights are reserved by the Publisher, whether the whole or part of
the material is concerned, specifically the rights of translation, reprinting, reuse of illustrations,
recitation, broadcasting, reproduction on microfilms or in any other physical way, and transmission or
information storage and retrieval, electronic adaptation, computer software, or by similar or dissimilar
methodology now known or hereafter developed.
The use of general descriptive names, registered names, trademarks, service marks, etc. in this
publication does not imply, even in the absence of a specific statement, that such names are exempt
from the relevant protective laws and regulations and therefore free for general use.
The publisher, the authors and the editors are safe to assume that the advice and information in this
book are believed to be true and accurate at the date of publication. Neither the publisher nor the
authors or the editors give a warranty, express or implied, with respect to the material contained herein
or for any errors or omissions that may have been made. The publisher remains neutral with regard to
jurisdictional claims in published maps and institutional affiliations.
Printed on acid-free paper
This Springer imprint is published by Springer Nature
The registered company is Springer-Verlag GmbH Berlin Heidelberg
The registered company address is: Heidelberger Platz 3, 14197 Berlin, Germany

v
Contents
I The Basics
1 Introduction ....................................................................................................................... 3
Michael Korenkov, Christoph-omas Germer, and Hauke Lang
2 Risk Assessment and Decision Analysis Within
Surgical Applications ..................................................................................................... 7
Benjamin D. Trump, Nicolas Pabon, Michelle Barber, Richard Hartz,
Faina Linkov, and Igor Linkov
3 Deviation from Surgical Standards from a Viewpoint of Layers ................. 19
Hermann Fenger
4 Surgeon in a Difficult Situation .................................................................................. 25
Hans Troidl
II Individual Surgery for Upside Down Stomach and
Antireflux Surgery
5 Introduction ....................................................................................................................... 33
Michael Korenkov, Christoph-omas Germer, and Hauke Lang
6 Surgical Technique and Difficult Situations from
Bernard Dallemagne ....................................................................................................... 39
Bernard Dallemagne
7 Surgical Technique and Difficult Situations from Hubertus Feussner ...... 43
Hubertus Feussner and Dirk Wilhelm
8 Surgical Technique and Difficult Situations from
Karl-Hermann Fuchs ....................................................................................................... 51
Karl-Hermann Fuchs, W. Breithaupt, G. Varga, T. Schulz, and B. Babic
9 Surgical Technique and Difficult Situations from Sumeet K. Mittal ........... 57
Pradeep Pallati and Sumeet K. Mittal
10 Surgical Technique and Difficult Situations from Nathaniel J. Soper ....... 65
Eric S. Hungness and Nathaniel J. Soper
11 Surgical Technique and Difficult Situations from David I. Watson ............. 69
David I. Watson
12 Single-Access- Laparoscopy and Foregut- Surgery
from Giovanni Dapri ....................................................................................................... 77
Giovanni Dapri

vi
Contents
13 Gastric Bypass After Failed Fundoplication from
Dimitrios Stefanidis ........................................................................................................ 87
Dimitrios Stefanidis
III Individual Surgery for Gastric Gastrointestinal
Stromal Tumors
14 Introduction ....................................................................................................................... 95
Michael Korenkov, Christoph-omas Germer, and Hauke Lang
15 Surgical Technique and Difficult Situations During the
Gastric Sleeve Resection from Michel Gagner..................................................... 99
Michel Gagner
16 Surgical Technique and Difficult Situations from
Chandrajit Raut ................................................................................................................. 107
Nicole J. Look Hong and Chandrajit P. Raut
IV Individual Surgery for Gastric Cancer
17 Introduction ....................................................................................................................... 119
Michael Korenkov, Christoph-omas Germer, and Hauke Lang
18 Surgical Technique and Difficult Situations from Francesco
Corcione (Laparoscopic) ................................................................................................ 125
Francesco Corcione and Pierluigi Angelini
19 Surgical Technique and Difficult Situations from
Arnulf H. Hoelscher (Conventional) ......................................................................... 131
Arnulf H. Hoelscher
20 Operative Technique and Difficult Situations by
Joachim Jähne (Conventional) ................................................................................... 143
Joachim Jähne
21 Surgical Technique and Difficult Situations from
Giovanni de Manzoni (Conventional) ...................................................................... 155
Giovanni de Manzoni, Simone Giacopuzzi, Maria Bencivenga,
and Enhao Zhao
V Individual Surgery for Benign Gallbladder
and Bile Ducts Diseases
22 Introduction ....................................................................................................................... 165
Michael Korenkov, Christoph-omas Germer, and Hauke Lang
23 Surgical Technique and Difficult Situations from Francesco Crafa ............. 169
Francesco Paolo Prete, Mario Baiamonte, Francesco Ruotolo, Francesco Bavetta,
and Francesco Crafa

Contents
24 Surgical Technique and Difficult Situations from Benoit Navez .................. 187
Benoit Navez
vii
VI Individual Surgery for Inflammatory Bowel Disease
25 Surgical Technique and Difficult Situations for Ulcerative
Colitis from Adrian Greenstein ................................................................................... 193
Alexander J. Greenstein and Adrian J. Greenstein
26 Surgical Technique and Difficult Situations
for Crohn Disease from Adrian Greenstein ........................................................... 201
Alexander J. Greenstein and Adrian J. Greenstein
27 Surgical Technique and Difficult Situations
from Karl-Heinz Vestweber .......................................................................................... 209
Karl-Heinz Vestweber
VII Individual Surgery for Right Hemicolectomy
28 Introduction ....................................................................................................................... 229
Michael Korenkov, Christoph-omas Germer, and Hauke Lang
29 Surgical Technique and Difficult Situations from
Roberto Bergamaschi (Laparoscopic) ..................................................................... 235
Seth A. Stein and Roberto C.M. Bergamaschi
30 Surgical Technique and Difficult Situations from
Alain Gainant (Conventional) ..................................................................................... 243
Alain Gainant
31 Surgical Technique and Difficult Situations from
Werner Hohenberger (Conventional) ...................................................................... 249
Werner Hohenberger
32 Surgical Technique and Difficult Situations from
Stefano Saad (Laparoscopic) ....................................................................................... 255
Stefano Saad
VIII Individual Surgery for Left Hemicolectomy
33 Introduction ....................................................................................................................... 263
Michael Korenkov, Christoph-omas Germer, and Hauke Lang
34 Surgical Technique and Difficult Situations by Joerg C. Kalff
(Conventional) ................................................................................................................... 267
Joerg C. Kal, Dimitrios Pantelis, and Burkhard Stoels
35 Surgical Technique and Difficult Situations from
Amjad Parvaiz: Splenic Flexure Tumors (Laparoscopic).................................. 273
Amjad Parvaiz and Manfred Odermatt

viii
Contents
36 Surgical Technique and Difficult Situations from
Thomas Schiedeck (Laparoscopic) ........................................................................... 281
omas H.K. Schiedeck and Marten Schmerer
IX Individual Surgery for Sigmoid Diverticulitis
37 Difficult Situations During the Surgery for Sigmoid
Diverticulitis ....................................................................................................................... 289
Susan Galandiuk
38 Surgical Technique and Difficult Situations from
Jakob R. Izbicki .................................................................................................................. 295
Jakob R. Izbicki and Kai Bachmann
X Individual Surgery for Rectal Cancer
39 Introduction ....................................................................................................................... 303
Michael Korenkov, Christoph-omas Germer, and Hauke Lang
40 Surgical Technique and Difficult Situations from
Matthias Anthuber .......................................................................................................... 309
Matthias Anthuber
41 Surgical Technique and Difficult Situations from
Markus W. Buechler (Conventional) ......................................................................... 315
Alexis Ulrich, P. Antony, and Markus W. Buechler
42 Surgical Technique and Difficult Situations from Alois Fuerst
(Laparoscopic) ................................................................................................................... 323
Alois Fuerst, Arthur Heiligensetzer, Gudrun Liebig-Hörl, and Peter Sauer
43 Surgical Technique and Difficult Situations from
Werner Hohenberger (Conventional) ...................................................................... 327
Werner Hohenberger
44 Surgical Technique and Difficult Situations from
Rolv-Ole Lindsetmo (Laparoscopic) ......................................................................... 333
Kim Erlend Mortensen, Stig Norderval, and Rolv-Ole Lindsetmo
45 Surgical Technique and Difficult Situations from
Neil Mortensen (Laparoscopic) .................................................................................. 343
J.B. Tuynman and N.J. Mortensen
46 Surgical Technique and Difficult Situations
from Amjad Parvaiz (Laparoscopic) ......................................................................... 351
Amjad Parvaiz and Manfred Odermatt

Contents
47 Surgical Technique and Difficult Situations from Peter M. Sagar
ix
(Conventional, Abdomino- Sacral Resection) ....................................................... 363
Peter M. Sagar
48 Surgical Technique and Difficult Situations from
Juergen Weitz (Conventional) ..................................................................................... 371
Christoph Reißfelder and Juergen Weitz
49 Surgical Technique and Difficult Situations from
Steven Wexner (Laparoscopic) ................................................................................... 377
Steven Wexner and Marc Osborne
50 Pelvic Autonomic Nerve Preservation during Total
Mesorectal Excision (TME) from Werner Kneist .................................................. 383
Werner Kneist
XI Individual Surgery for Rectal Prolapse
51 Introduction ....................................................................................................................... 407
Michael Korenkov, Christoph-omas Germer, and Hauke Lang
52 Surgical Technique and Difficult Situations from
Karl-Hermann Fuchs (Laparoscopic Resection Rectopexy) ........................... 411
Karl-Hermann Fuchs, W. Breithaupt, and B. Babic
53 Surgical Technique and Difficult Situations from
David Jayne (Laparoscopic Ventral Rectopexy) .................................................. 415
Jim Tiernan and David Jayne
54 Surgical Technique and Difficult Situations from
Antonio Longo (Different Techniques) ................................................................... 421
Antonio Longo
Supplementary Information
Index .......................................................................................................................................
435

Contributors
xi
Pierluigi Angelini
General Surgery Department
Laparoscopic and Robotic Surgery Center
Naples
Italy
Highly Specialized and of National Importance
Hospital “V. Monaldi”
Naples
Italy
Matthias Anthuber
Department of General,
Visceral and Transplantation Surgery
Klinikum Augsburg
Augsburg
Germany
P. Antony
Department of General,
Visceral and Transplantation Surgery
University of Heidelberg,
University Hospital Heidelberg
Heidelberg
Germany
Michelle Barber
U.S. Army Engineer Research and
Development Center
Vicksburg
MS
USA
Francesco Bavetta
Department of Surgical Sciences
University College Hospital
London
UK
Maria Bencivenga
Upper GI Surgery Division
University of Verona
Verona
Italy
Roberto C. M. Bergamaschi
Division of Colon and Rectal Surgery
State University of New York
Stony Brook
NY
USA
B. Babic
Department of Surgery
AGAPLESION Markus Krankenhaus
Frankfurt
Germany
Kai Bachmann
Department of General,
Visceral and Thoracic Surgery
University Medical Center HamburgEppendorf
Hamburg
Germany
Mario Baiamonte
Department of Surgical Sciences
University College Hospital
London
UK
W. Breithaupt
Department of Surgery
AGAPLESION Markus Krankenhaus
Frankfurt
Germany
Markus W. Buechler
Department of General,
Visceral and Transplantation Surgery
University of Heidelberg,
University Hospital Heidelberg
Heidelberg
Germany
Francesco Corcione
General Surgery Department
Laparoscopic and Robotic Surgery Center
Naples
Italy
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