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 Shenzhen 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.

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

我仅代表中山大学附属第六院消化外科对本届年会的顺利举办表示热烈的祝贺,并对提供交流集会的香港平台表示衷心的感谢。

Hereby, on behalf of the Sixth Affiliated Hospital of Shanyangshan 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.

首先,我为大家介绍我所服务的医院。

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家综合性医院。

The sixth affiliated hospital of St. Justin University

is a tertiary hospital focusing on clinical care, research, rehabilitation and prevention, etc.

中山大学十佳植树附属医院之一。

It is one of the ten affiliated hospitals of Shenzhen University in China.

六院的专科特色鲜明,以建立胃肠疾病国际临床科研中心并形成全国影响力。

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 licensed beds.

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.

我愿中视科研平台的建设,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年获批广东省结基层本地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 were 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 minimally invasive technologies.

Also, we 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.

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

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

把消化外科手术的新经验、新技术、新方法传授给临床一线工作者,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 Go.

目前有十个胃肠肝门外科病区。

There are ten 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.

There are three endoscopic services, each of them focusing on gastrointestinal, endoscopic surgery service, 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.

The research institutes include Gastroenterology Institute,

Also, we are organizing three key national journals, for example, the China Gastroenterology Journal,

中华炎性肠病杂志,

China Gastrointestinal Inflammatory Diseases Journal,

一本英文杂志是未尝报道,

and one English-based journal of gastroenterology updates.

目前第一位直肠癌保肝关键技术体系,

获得2016年国家科技进步二等奖

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

in the National Science and Technology Progress Award for 2016

目前建立一个标准,两厘米的宝钢新标准

We've established one standard, that is the 2-centimeter preservation of the anus

保肛率从28.2%提升至79.4%

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%

创立一个方案,单纯新辅助化疗方案,以降低直上癌的分歧

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

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

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.

2021年2月,获批国家消化系统疾病临床医学研究中心,广东省分中心。

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

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

专生本教材外科学

消化系统与治病第二版

副主编内科学第七版

edition of the medicine textbook.

外科学英文版

We also author the English edition

for the textbook surgery.

牵头制定指南规范

We are one of the developing units,

developing institutes for guidelines.

中国急伤癌诊疗规范

2010, 2015, 2017, 2020版

We've participated in the development

We have also authored the 2010th edition of Guidelines on Liver Metastasis from Colorectal Carcinoma.

We've authored the Expert Consensus on Inflammatory Bowel Diseases.

We've authored the Expert Consensus on Preventing Postoperative Complications for Inflammatory Bowel Diseases.

便秘外科诊治专家共识2010版

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

教育部科技进步一等奖一项

广东省科技进步一等奖三项

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 Systems Congress of Guangzhou.

Next, Professor Huang will present the patient case

and share the highlights of the surgery,

laparoscopic right radical hemicolectomy.

患者一般情况,女性56岁。

This is a woman of 56 years old.

大病时光改变约三个月。

She recognized change of habitus of bowel movement in the past three months.

结肠镜结果提示生结肠肿瘤,活检病理为腺癌。

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.

Here is the setup with five portal.

这是显示肿瘤的位置以及我们切除的范围。

Location of the tumor and the size of resection.

手术开始,就是速冲探查。

Laparoscopic examination.

这个走杆,刚才要杆到走杆。

The liver from left to right.

肿瘤探查。

And examining the tumor.

这个提示我们显示从尾侧入入,联合中间。

We took the cordial and medial approach.

We are mobilizing the ilioclonic pedicles.

And extend it to the totes fascia.

So we went through a caudal and medial approach

and start the mobilization from the right iliocollic pedicures.

Pre-op workup indicating locally advanced disease,

so we adopted the D2 strategy.

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

As we mobilize, we meet the ileocolic artery

and ligate it at the root.

We continue to mobilize the ileocolic vein and dissect it.

As we are performing a D2 colectomate, 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've 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 SME.

Now we are mobilizing the right colic artery.

那现在是在一线表面做拓展游离。

在一线表面拓展游离的时候,注意荷兰干分支以及变异。

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

十二指腸上前静脉和网膜右静脉合成,但是大部分病人还是有变异。

On the anterior space of pancreas, we may be able to observe the composition of the head and 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 hair and trunk.

Now comes to the right gastric vein.

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

As the cancer is in the ascending colon,

so as we approach it from the caudal direction,

we are mobilizing the right gastroepiploitic vein.

Many surgeons believe that by going through the cordal approach,

we need to mobilize lateral to the arch.

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

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 antifield.

And the vascular branches.

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.

生死部队。

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 550 milliliters of blood loss.

排气时间术后三天

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.

术后病理分歧是T3,M0,M0

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.