slawomir marecik, md, facs, fascrs advocate lutheran general hospital, park ridge, il clinical...
TRANSCRIPT
![Page 1: Slawomir Marecik, MD, FACS, FASCRS Advocate Lutheran General Hospital, Park Ridge, IL Clinical Assistant Professor University of Illinois, Chicago, USA](https://reader030.vdocuments.net/reader030/viewer/2022032705/56649d965503460f94a7ea6d/html5/thumbnails/1.jpg)
COLORECTAL and robotic SURGERIES
Slawomir Marecik, MD, FACS, FASCRSAdvocate Lutheran General Hospital, Park Ridge, ILClinical Assistant ProfessorUniversity of Illinois, Chicago, USA
![Page 2: Slawomir Marecik, MD, FACS, FASCRS Advocate Lutheran General Hospital, Park Ridge, IL Clinical Assistant Professor University of Illinois, Chicago, USA](https://reader030.vdocuments.net/reader030/viewer/2022032705/56649d965503460f94a7ea6d/html5/thumbnails/2.jpg)
Outline Anatomy Colon cancer Rectal cancer Diverticular disease Inflammatory bowel disease
Crohn’s disease Ulcerative colitis
![Page 3: Slawomir Marecik, MD, FACS, FASCRS Advocate Lutheran General Hospital, Park Ridge, IL Clinical Assistant Professor University of Illinois, Chicago, USA](https://reader030.vdocuments.net/reader030/viewer/2022032705/56649d965503460f94a7ea6d/html5/thumbnails/3.jpg)
Anatomy How long is your colon?
![Page 4: Slawomir Marecik, MD, FACS, FASCRS Advocate Lutheran General Hospital, Park Ridge, IL Clinical Assistant Professor University of Illinois, Chicago, USA](https://reader030.vdocuments.net/reader030/viewer/2022032705/56649d965503460f94a7ea6d/html5/thumbnails/4.jpg)
Anatomy picture of the colon lymph nodes vessels retroperitoneal part perforations
![Page 5: Slawomir Marecik, MD, FACS, FASCRS Advocate Lutheran General Hospital, Park Ridge, IL Clinical Assistant Professor University of Illinois, Chicago, USA](https://reader030.vdocuments.net/reader030/viewer/2022032705/56649d965503460f94a7ea6d/html5/thumbnails/5.jpg)
![Page 6: Slawomir Marecik, MD, FACS, FASCRS Advocate Lutheran General Hospital, Park Ridge, IL Clinical Assistant Professor University of Illinois, Chicago, USA](https://reader030.vdocuments.net/reader030/viewer/2022032705/56649d965503460f94a7ea6d/html5/thumbnails/6.jpg)
![Page 7: Slawomir Marecik, MD, FACS, FASCRS Advocate Lutheran General Hospital, Park Ridge, IL Clinical Assistant Professor University of Illinois, Chicago, USA](https://reader030.vdocuments.net/reader030/viewer/2022032705/56649d965503460f94a7ea6d/html5/thumbnails/7.jpg)
![Page 8: Slawomir Marecik, MD, FACS, FASCRS Advocate Lutheran General Hospital, Park Ridge, IL Clinical Assistant Professor University of Illinois, Chicago, USA](https://reader030.vdocuments.net/reader030/viewer/2022032705/56649d965503460f94a7ea6d/html5/thumbnails/8.jpg)
![Page 9: Slawomir Marecik, MD, FACS, FASCRS Advocate Lutheran General Hospital, Park Ridge, IL Clinical Assistant Professor University of Illinois, Chicago, USA](https://reader030.vdocuments.net/reader030/viewer/2022032705/56649d965503460f94a7ea6d/html5/thumbnails/9.jpg)
![Page 10: Slawomir Marecik, MD, FACS, FASCRS Advocate Lutheran General Hospital, Park Ridge, IL Clinical Assistant Professor University of Illinois, Chicago, USA](https://reader030.vdocuments.net/reader030/viewer/2022032705/56649d965503460f94a7ea6d/html5/thumbnails/10.jpg)
![Page 11: Slawomir Marecik, MD, FACS, FASCRS Advocate Lutheran General Hospital, Park Ridge, IL Clinical Assistant Professor University of Illinois, Chicago, USA](https://reader030.vdocuments.net/reader030/viewer/2022032705/56649d965503460f94a7ea6d/html5/thumbnails/11.jpg)
![Page 12: Slawomir Marecik, MD, FACS, FASCRS Advocate Lutheran General Hospital, Park Ridge, IL Clinical Assistant Professor University of Illinois, Chicago, USA](https://reader030.vdocuments.net/reader030/viewer/2022032705/56649d965503460f94a7ea6d/html5/thumbnails/12.jpg)
![Page 13: Slawomir Marecik, MD, FACS, FASCRS Advocate Lutheran General Hospital, Park Ridge, IL Clinical Assistant Professor University of Illinois, Chicago, USA](https://reader030.vdocuments.net/reader030/viewer/2022032705/56649d965503460f94a7ea6d/html5/thumbnails/13.jpg)
Anatomy video full colon inside live
![Page 14: Slawomir Marecik, MD, FACS, FASCRS Advocate Lutheran General Hospital, Park Ridge, IL Clinical Assistant Professor University of Illinois, Chicago, USA](https://reader030.vdocuments.net/reader030/viewer/2022032705/56649d965503460f94a7ea6d/html5/thumbnails/14.jpg)
Anatomy video of right colon specimen video of left colon and rectum specimen
![Page 15: Slawomir Marecik, MD, FACS, FASCRS Advocate Lutheran General Hospital, Park Ridge, IL Clinical Assistant Professor University of Illinois, Chicago, USA](https://reader030.vdocuments.net/reader030/viewer/2022032705/56649d965503460f94a7ea6d/html5/thumbnails/15.jpg)
Colon cancer pictures right colon transverse left colon sigmoid
![Page 16: Slawomir Marecik, MD, FACS, FASCRS Advocate Lutheran General Hospital, Park Ridge, IL Clinical Assistant Professor University of Illinois, Chicago, USA](https://reader030.vdocuments.net/reader030/viewer/2022032705/56649d965503460f94a7ea6d/html5/thumbnails/16.jpg)
Colon cancer
![Page 17: Slawomir Marecik, MD, FACS, FASCRS Advocate Lutheran General Hospital, Park Ridge, IL Clinical Assistant Professor University of Illinois, Chicago, USA](https://reader030.vdocuments.net/reader030/viewer/2022032705/56649d965503460f94a7ea6d/html5/thumbnails/17.jpg)
![Page 18: Slawomir Marecik, MD, FACS, FASCRS Advocate Lutheran General Hospital, Park Ridge, IL Clinical Assistant Professor University of Illinois, Chicago, USA](https://reader030.vdocuments.net/reader030/viewer/2022032705/56649d965503460f94a7ea6d/html5/thumbnails/18.jpg)
Colon cancer type of operations type of anastomosis how the anastomosis is created stapling
![Page 19: Slawomir Marecik, MD, FACS, FASCRS Advocate Lutheran General Hospital, Park Ridge, IL Clinical Assistant Professor University of Illinois, Chicago, USA](https://reader030.vdocuments.net/reader030/viewer/2022032705/56649d965503460f94a7ea6d/html5/thumbnails/19.jpg)
![Page 20: Slawomir Marecik, MD, FACS, FASCRS Advocate Lutheran General Hospital, Park Ridge, IL Clinical Assistant Professor University of Illinois, Chicago, USA](https://reader030.vdocuments.net/reader030/viewer/2022032705/56649d965503460f94a7ea6d/html5/thumbnails/20.jpg)
Type of anastomosis Hand-sewn Stapled
Linear stapler Circular stapler
![Page 21: Slawomir Marecik, MD, FACS, FASCRS Advocate Lutheran General Hospital, Park Ridge, IL Clinical Assistant Professor University of Illinois, Chicago, USA](https://reader030.vdocuments.net/reader030/viewer/2022032705/56649d965503460f94a7ea6d/html5/thumbnails/21.jpg)
Hand-sewn anastomosis
![Page 22: Slawomir Marecik, MD, FACS, FASCRS Advocate Lutheran General Hospital, Park Ridge, IL Clinical Assistant Professor University of Illinois, Chicago, USA](https://reader030.vdocuments.net/reader030/viewer/2022032705/56649d965503460f94a7ea6d/html5/thumbnails/22.jpg)
Stapled, linear
![Page 23: Slawomir Marecik, MD, FACS, FASCRS Advocate Lutheran General Hospital, Park Ridge, IL Clinical Assistant Professor University of Illinois, Chicago, USA](https://reader030.vdocuments.net/reader030/viewer/2022032705/56649d965503460f94a7ea6d/html5/thumbnails/23.jpg)
Stapled, circular
![Page 24: Slawomir Marecik, MD, FACS, FASCRS Advocate Lutheran General Hospital, Park Ridge, IL Clinical Assistant Professor University of Illinois, Chicago, USA](https://reader030.vdocuments.net/reader030/viewer/2022032705/56649d965503460f94a7ea6d/html5/thumbnails/24.jpg)
![Page 25: Slawomir Marecik, MD, FACS, FASCRS Advocate Lutheran General Hospital, Park Ridge, IL Clinical Assistant Professor University of Illinois, Chicago, USA](https://reader030.vdocuments.net/reader030/viewer/2022032705/56649d965503460f94a7ea6d/html5/thumbnails/25.jpg)
Colon cancer When is colostomy needed?
emergency situation when… bowel is not prepared (bowel prep) patient has no healing potential
poor nutrition poor vascular supply steroids, other severe conditions
![Page 26: Slawomir Marecik, MD, FACS, FASCRS Advocate Lutheran General Hospital, Park Ridge, IL Clinical Assistant Professor University of Illinois, Chicago, USA](https://reader030.vdocuments.net/reader030/viewer/2022032705/56649d965503460f94a7ea6d/html5/thumbnails/26.jpg)
Rectal cancer Anatomy
mesorectum, valves, lymph nodes sphincter
![Page 27: Slawomir Marecik, MD, FACS, FASCRS Advocate Lutheran General Hospital, Park Ridge, IL Clinical Assistant Professor University of Illinois, Chicago, USA](https://reader030.vdocuments.net/reader030/viewer/2022032705/56649d965503460f94a7ea6d/html5/thumbnails/27.jpg)
![Page 28: Slawomir Marecik, MD, FACS, FASCRS Advocate Lutheran General Hospital, Park Ridge, IL Clinical Assistant Professor University of Illinois, Chicago, USA](https://reader030.vdocuments.net/reader030/viewer/2022032705/56649d965503460f94a7ea6d/html5/thumbnails/28.jpg)
![Page 29: Slawomir Marecik, MD, FACS, FASCRS Advocate Lutheran General Hospital, Park Ridge, IL Clinical Assistant Professor University of Illinois, Chicago, USA](https://reader030.vdocuments.net/reader030/viewer/2022032705/56649d965503460f94a7ea6d/html5/thumbnails/29.jpg)
![Page 30: Slawomir Marecik, MD, FACS, FASCRS Advocate Lutheran General Hospital, Park Ridge, IL Clinical Assistant Professor University of Illinois, Chicago, USA](https://reader030.vdocuments.net/reader030/viewer/2022032705/56649d965503460f94a7ea6d/html5/thumbnails/30.jpg)
Rectal cancer Level of tumor
![Page 31: Slawomir Marecik, MD, FACS, FASCRS Advocate Lutheran General Hospital, Park Ridge, IL Clinical Assistant Professor University of Illinois, Chicago, USA](https://reader030.vdocuments.net/reader030/viewer/2022032705/56649d965503460f94a7ea6d/html5/thumbnails/31.jpg)
Type of operations endoscopic excision local (transanal) excision radical surgery (involving bowel and lymph
nodes) radical surgery with sphincter
![Page 32: Slawomir Marecik, MD, FACS, FASCRS Advocate Lutheran General Hospital, Park Ridge, IL Clinical Assistant Professor University of Illinois, Chicago, USA](https://reader030.vdocuments.net/reader030/viewer/2022032705/56649d965503460f94a7ea6d/html5/thumbnails/32.jpg)
ANTERIOR RESECTION
ULTRALOW ANTERIOR RESECTION
LOW ANTERIOR RESECTION
COLOANALPULLTHROUGH
![Page 33: Slawomir Marecik, MD, FACS, FASCRS Advocate Lutheran General Hospital, Park Ridge, IL Clinical Assistant Professor University of Illinois, Chicago, USA](https://reader030.vdocuments.net/reader030/viewer/2022032705/56649d965503460f94a7ea6d/html5/thumbnails/33.jpg)
Rectal cancer When is colostomy needed?
tumor involving the sphincter poor preoperative continence
When is (protective) ileostomy needed? low pelvic anastomosis if radiation was given before surgery
![Page 34: Slawomir Marecik, MD, FACS, FASCRS Advocate Lutheran General Hospital, Park Ridge, IL Clinical Assistant Professor University of Illinois, Chicago, USA](https://reader030.vdocuments.net/reader030/viewer/2022032705/56649d965503460f94a7ea6d/html5/thumbnails/34.jpg)
Need for proper evaluation endoscopy ultrasound MRI
![Page 35: Slawomir Marecik, MD, FACS, FASCRS Advocate Lutheran General Hospital, Park Ridge, IL Clinical Assistant Professor University of Illinois, Chicago, USA](https://reader030.vdocuments.net/reader030/viewer/2022032705/56649d965503460f94a7ea6d/html5/thumbnails/35.jpg)
Types of reconstruction after rectal cancer surgery
Straight connection J pouch Side to end
video
![Page 36: Slawomir Marecik, MD, FACS, FASCRS Advocate Lutheran General Hospital, Park Ridge, IL Clinical Assistant Professor University of Illinois, Chicago, USA](https://reader030.vdocuments.net/reader030/viewer/2022032705/56649d965503460f94a7ea6d/html5/thumbnails/36.jpg)
![Page 37: Slawomir Marecik, MD, FACS, FASCRS Advocate Lutheran General Hospital, Park Ridge, IL Clinical Assistant Professor University of Illinois, Chicago, USA](https://reader030.vdocuments.net/reader030/viewer/2022032705/56649d965503460f94a7ea6d/html5/thumbnails/37.jpg)
![Page 38: Slawomir Marecik, MD, FACS, FASCRS Advocate Lutheran General Hospital, Park Ridge, IL Clinical Assistant Professor University of Illinois, Chicago, USA](https://reader030.vdocuments.net/reader030/viewer/2022032705/56649d965503460f94a7ea6d/html5/thumbnails/38.jpg)
![Page 39: Slawomir Marecik, MD, FACS, FASCRS Advocate Lutheran General Hospital, Park Ridge, IL Clinical Assistant Professor University of Illinois, Chicago, USA](https://reader030.vdocuments.net/reader030/viewer/2022032705/56649d965503460f94a7ea6d/html5/thumbnails/39.jpg)
preoperative chemoradiation therapy when? how long? why ileostomy? why pouchogram and flex sig?
![Page 40: Slawomir Marecik, MD, FACS, FASCRS Advocate Lutheran General Hospital, Park Ridge, IL Clinical Assistant Professor University of Illinois, Chicago, USA](https://reader030.vdocuments.net/reader030/viewer/2022032705/56649d965503460f94a7ea6d/html5/thumbnails/40.jpg)
Video – rectal cancer surgery Total mesorectal excision