Multipe Polypes And Subtotal Excision Of The Colon

Background: Minimally invasive subtotal colon removal is considered one of the most complicated and compound interventions in laparoscopic procedures, performed on the colon and rectum. There are a few advantages of laparoscopic surgery e.g.: no pain after excision, little scarrying, faster recovery and less time spend in the hospital before discharge. However, we need to be conscious of the disadvantages of laparoscopy, such as longer duration of the procedure as well as more risk of post- and intrasurgical complications. Case report: A minimally invasive subtotal colon excision due to multipolyposis, was performed on a 55-year-old male. Before surgery, a colonoscopy was ordered and indicated multipe polypes of the colon. Histological exam revealed a dysplasia-from moderate to severe. Intervention: The transverse colon mobilization together with middle colic veins and arteries partition is considered to be the longest part of the excision. Each siding was founded carefully and verified proximally. Due to hard dissection of this region, a deep anatomical knowlege of the vessels is of the highest importance. Is is necessarly to ensure the pedicle of the veins and arteries, because mesenteric vessels are situated deep and the pancreas is totally visualized. Conclusions: The laparoscopic management of colon subtotal excision has many advantages, such as avoiding a large midline skin incision (shorter McBurney incision is used in this case) and the postoperative recovery time is much shorter. However, minimally invasive procedure requires technical advancement as well as clinical experience and proper qulification of the patients. Authors: Giancarlo Basili, MD, Luca Lorenzetti, MD, Graziano Biondi, MD, Orlando Goletti, MD