RELIVE Prof. HUANG MeiJin_Laparoscopic Right Radical Hemicolectomy

The speaker today is Professor Huang Meijing.

Professor Huang is Deputy President and Director of Colorectal Surgery Unit 1

of the Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.

He is the Chair of Gastroenterology Chapter, China Anti-Cancer Association Rehabilitation Society.

With 28 years of gastrointestinal surgical practice,

Professor Huang's expertise includes radical surgeries for colorectal carcinoma, gastric carcinoma, and neoplasms of the pancreatic body and tail.

He will demonstrate laparoscopic right radical hemicolectomy.

Dear Chairperson, colleagues, ladies and gentlemen, good afternoon.

It's my honor to be a part of the 33rd Annual Meeting of the Italian Gastrointestinal Diseases.

经过多方努力,我们得以与全球消化外科领域的红鱼硕学相致云端切磋交流。

With all the efforts, we've made it to the webinar with global gastrointestinal experts to share on expertise.

在此,我仅代表中山大学附属第六院手法外科对本届年会的顺利举办表示热烈的祝贺,

并对提供交流机会的相关平台表示衷心的感谢。

Hereby, on behalf of the Sixth Affiliated Hospital of Sun Yat-sen University Gastrointestinal Services,

I'd like to extend the warmest congratulations to the success of the meeting and thank all the platforms and staff for organizing the meeting.

First of all, a few information about the organizations that I work in.

中山大学附属第六院是一所执医疗、教学、科研、预防和健康保健等为一体的三甲综合性医院。

The sixth affiliated hospital of Shenzhen University is a tertiary hospital focusing on clinical care, research, rehabilitation and prevention, etc.

为中山大学十家直属附属医院之一。

It is one of the 10 affiliated hospitals of Sun Yat-sen University in China.

Our signature service is gastrointestinal services.

We are well known across the country.

高级直窗58人,设计专科床位797张。

We've got 58 staff with senior academic title, and we've got 797 license bets.

拥有国内最高水平之一的机场肿瘤,胃肿瘤会诊诊治中心。

We are known as a top national and international center for colorectal cancer, colorectal diseases and gastric diseases.

我愿重视科研平台的建设,实现基础研究,临床研究和转化研究平台,相互支撑发展。

We focus a lot on research, including basic research, clinical research, and translational research.

2010年获批广东省结极肠本体疾病研究重点实验室。

For example, in 2010, we were licensed as the Provincial Center for Gastrointestinal and Pelvic Diseases.

And in 2019, we was regarded as the Provincial Center for Gastrointestinal Diseases.

Also, in 2020, we established the AI Institute and Biomaterial Institute for Clinical Care.

We aim for providing personalized and one-stop management of gastrointestinal diseases with many, many invasive technologies.

We also focus on minimally invasive treatment for critical abdominal infection, as well as enteral and parenteral nutrition for patients in critical condition.

Over the years, we've been active in global communication and academic exchanges.

以国外多个著名的胃肠疾病中心建立了长期友好的双边交流合作关系。

We've been long-term partners with global well-known institutes.

保证整流技术、科学研究和学术活动以国际先进水平同步。

So that we can ensure we keep pace with the world in terms of technologies and expertise and clinical care.

此次手术年会,凭借最现代、最高效的技术,通过马拉松式的手术直播,以全球精英共享消化外科领域进展。

This annual conference features a marathon of surgeries so that colleagues around the globe can come and appreciate techniques and technologies.

助力实现2030健康中国的伟大愿景。

Therefore, we look forward to demonstrate the clinical practice and learn from new technologies.

By doing so, we will spread the technologies and methods of clinical care as our way to contribute to the 2030 Healthy China Goal.

我们胃肠肛门疾病整治中心目前有10个胃肠肛门外科病区。

There are 10 units in our gastrointestinal and proctology services.

两个消化内科病区

In addition, there are two medical units for gastrointestinal diseases.

两个胃肠肿瘤内科病区

Two medical oncological gastroenterology units.

一个放疗病区

One radiotherapy unit.

三个内静中心

There are three endoscopic surfaces, each of them focusing on gastrointestinal endoscopic surgery surface and intestinal endoscopies.

近年来每年肠癌手术例数在4,000台以上,2021年近4,500台。

Over recent years, we've performed more than 4,000 surgeries for colorectal carcinoma,

and in 2021, this number reached 4,500.

目前高级支撑60余人,博士生导师38人,硕士生导师80人。

Now there are more than 60 staff with a senior academic title, 38 supervisors for Ph.D. and 80 supervisors for graduate students.

目前研究平台的建设有胃腸病学研究所。

The research institutes include Gastroenterology Institute.

接触上海筛查中心。

Colorado Cancer Screening Center.

肠道维生态研究中心。

Intestinal Microenvironment Research Institute

Clinical Research Institute

Medical AI Institute

Also, we are organizing three key national journals.

For example, the China Gastroenterology Journal

China Gastrointestinal Inflammatory Diseases Journal

and One English-based Journal of Gastroenterology Updates.

Our work in the low-level resection was awarded the second prize

in the National Science and Technology Progress Award for 2016.

We've established one standard,

that is the 2 cm preservation of the anus.

Therefore, the anus preservation rate increased from 28.2%

to 79.4%.

创立两项保肛新技术。

We have authored two techniques for anus preservation.

实现超低位保肛。

Therefore, we managed to preserve the anus for the extremely low disease.

性功能障碍率从70%降至15.4%。

Injury to the sexual organs were reduced,

used, therefore, from 70% to 15%.

创立一个方案,单纯新辅助化疗方案,以降低直肠癌的分歧。

We also authored one protocol for isolated neuroadjuvant therapy that managed to downstage rectal cancer.

同时,对年轻生育区的肿瘤患者实现保全生育功能。

Also, we are good at preserving the reproductive function among young patients with reproductive age.

2019年10月,获批广东省唯一的消化系统疾病临床医学研究中心。

In October 2019, we were awarded the first and only provincial center for gastroenterology.

In February 2021, we were licensed as the Guangdong branch of the National Institute of Clinical Research.

主编国家统编教材,外科学第八版第九版。

We've been part of the editor and authors for the National Textbook of the 8th and the 9th Editions.

专身本教材外科学。

In addition to the National Surgery Textbook, we also author the textbooks for collateral degrees.

消化系统与殖病第二版 We've authored the second edition of the book

Gastrointestinal Diseases 副主编内科学第七版 We are the deputy editors for the seventh

edition of the medicine textbook 外科学英文版 We also authored the English edition

We are one of the developing units, developing institutes for guidelines.

We've participated in the development of China guidelines for colorectal diseases for many editions

from 2015, 2017, and 2020.

We have also authored the 2010 edition of

Guidelines on Liver Metastasis from Colorectal Carcinoma.

原性肠病诊治共识意见。

We've authored the expert consensus on inflammatory bowel diseases.

原性肠病术后并发症防治的共识意见。

We've authored the expert consensus on preventing post-operative complications for inflammatory bowel diseases.

便秘外科诊治专家共识20108。

and the Expert Consensus on Gastrointestinal Diseases for its 2010th edition.

中国放射性职场损伤多学科诊治专家共识2021年版

The 2012 edition of Expert Consensus for Proctal Diseases After Radiotherapy

科研奖项获得国家科技进步二等奖一项

In terms of award for science and technology, we've been awarded the second prize for the National Science and Technology Progress Award.

And won first prize award from the Education Ministry for Science and Technology Advancement.

We also received the first prize of Provincial Science and Technology Progress Award for three times.

And one second prize award of the Provincial Progress Award.

In terms of meetings, we've organized nine Digestive System Congress of

of Guangzhou.

Next, Professor Huang will present the patient case

and share the highlights of the surgery,

laparoscopic right radical hemicolectomy.

This is a woman of 56-year-old.

She recognized change of habitus of bowel movement

in the past three months.

Colonoscopy revealed a protrusion of the ascending colon, indicating adenocarcinoma.

Thoracal abdominal pelvic enhanced CT revealed protrusion and mass of the lower ascending colon with negative findings on liver or lungs.

imaging staging T2 to T3, N0, M0.

After bringing the case to the board,

we decided to perform a right colectomy under laparoscopy.

CT shows the tumor on the right side.

Here is the set up with five portal.

This is the location of the tumor and the size of resection.

Laparoscopic examination.

The liver from left to right.

And examining the tumor.

这个提示我们显示从尾侧入路,联合中间入路。

We took the cordial and medial approach.

这是在游离右回节肠动静脉。

We are mobilizing the ilioclonic pedicles.

从尾侧入路,这里是拓展这个左侧头头间隙。

And extend it to the toes fascia.

这是尾侧入路联合中间入路。

We went through a caudal and medial approach and started the mobilization from the right

ileocolic pedicures.

Pre-op workup indicating locally advanced disease, so we adopted D2 strategy.

意思就是在我们清扫的话,与尝试膜上静脉为边界进行清扫就可以达到目的。

That means our D-section would aim for the SMB as our marker, landmark.

那现在有力看到我们在这个回节肠动脉。

As we mobilize, we meet the ileocolic artery.

and ligated at the root.

We continue to mobilize the ileocollic vein and dissect it.

As we are performing a D2 colectomy,

that means all the vessels are ligated and dissected on the right side of SMV.

As we've mobilized and sealed and dissected the ileocolic pedicles,

we extended the dissection towards the totes fascia.

As we've finished the work from the corridor approach,

we move on to the medial approach and going along with the SMV.

Now we are mobilizing the right colliculatory.

We extend the dissection on the surface of pancreas.

As we mobilize along the pancreas, we need to be alert to the hemlock trunk or its variation.

On the surface on the anterior space of pancreas we may be able to observe the composition of

helen trunk namely the right gastroepiploic vein the right colic vein and the anterior superior

pancreatal duodenal vein however significant variation is observed

Now we are mobilizing the head and trunk

Now comes to the right gastric vein

腹腰静脉的屏幕的左下方是看到十二指肠上前移前静脉。

And on the left lower quarter of the camera shows the anterior superior pancreatic duodenal vein.

现在因为肿瘤是在上阶层吸取部,所以我们现在是从头侧入入,游离外网膜药的静脉。

As the cancer is in the ascending colon, so as we approach it from the caudal direction, we are mobilizing the right gastroepiphyloid vein.

Many surgeons believe that by going through the cordial approach,

we need to mobilize lateral to the arch.

However, we feel that station 6 had a lower yield as a positive node.

Therefore, we usually go through the medial side of the arch.

Because in this way, it is easier for the mobilization

and we can maintain a good visualization without risk of bleeding.

We usually adopt extracorporeal side-to-side anastomosis.

Also, we use suture for the seromuscular enhancement.

Here shows the anti-field

and the vascular branches.

最后也要关闭结肠裂孔。

Finally, we close the defect on the colon.

这还是手术窗面显示。

Here is the surgical field.

展示病理标本。

And the specimen.

生死部的,这是最后的病理报告。

Pathological report.

总统手术时长约120分钟,出血50毫升。

The surgery lasted for 120 minutes with 50 milliliters of blood loss.

排泄时间术后三天

And flatulence resumed on day three.

术后四天眼流管拔除

Drainage removed on day four.

术后住院时间六天

She was discharged six days after surgery.

绝后病理分歧是T3M0M0

The pathological result revealed T3, N0, and N0.

28 lymph nodes, all of them were negative.

Previously, Professor Huang shared the highlights of the surgery.

Now, the full-length video of the surgery is to be presented.

That's the end of the surgical live stream.

First of all, I'd like to extend the warmest congratulations to the success of the 33rd Digestive System Congress of Italy.

My thanks also goes to all the chairpersons, moderators, and staff of the meeting.

Thank you.