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COLORECTAL and robotic SURGERIES Slawomir Marecik, MD, FACS, FASCRS Advocate Lutheran General Hospital, Park Ridge, IL Clinical Assistant Professor University of Illinois, Chicago, USA

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Page 1: Slawomir Marecik, MD, FACS, FASCRS Advocate Lutheran General Hospital, Park Ridge, IL Clinical Assistant Professor University of Illinois, Chicago, USA

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

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

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

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
Page 6: Slawomir Marecik, MD, FACS, FASCRS Advocate Lutheran General Hospital, Park Ridge, IL Clinical Assistant Professor University of Illinois, Chicago, USA
Page 7: Slawomir Marecik, MD, FACS, FASCRS Advocate Lutheran General Hospital, Park Ridge, IL Clinical Assistant Professor University of Illinois, Chicago, USA
Page 8: Slawomir Marecik, MD, FACS, FASCRS Advocate Lutheran General Hospital, Park Ridge, IL Clinical Assistant Professor University of Illinois, Chicago, USA
Page 9: Slawomir Marecik, MD, FACS, FASCRS Advocate Lutheran General Hospital, Park Ridge, IL Clinical Assistant Professor University of Illinois, Chicago, USA
Page 10: Slawomir Marecik, MD, FACS, FASCRS Advocate Lutheran General Hospital, Park Ridge, IL Clinical Assistant Professor University of Illinois, Chicago, USA
Page 11: Slawomir Marecik, MD, FACS, FASCRS Advocate Lutheran General Hospital, Park Ridge, IL Clinical Assistant Professor University of Illinois, Chicago, USA
Page 12: Slawomir Marecik, MD, FACS, FASCRS Advocate Lutheran General Hospital, Park Ridge, IL Clinical Assistant Professor University of Illinois, Chicago, USA
Page 13: Slawomir Marecik, MD, FACS, FASCRS Advocate Lutheran General Hospital, Park Ridge, IL Clinical Assistant Professor University of Illinois, Chicago, USA

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

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

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

Colon cancer

Page 17: Slawomir Marecik, MD, FACS, FASCRS Advocate Lutheran General Hospital, Park Ridge, IL Clinical Assistant Professor University of Illinois, Chicago, USA
Page 18: Slawomir Marecik, MD, FACS, FASCRS Advocate Lutheran General Hospital, Park Ridge, IL Clinical Assistant Professor University of Illinois, Chicago, USA

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
Page 20: Slawomir Marecik, MD, FACS, FASCRS Advocate Lutheran General Hospital, Park Ridge, IL Clinical Assistant Professor University of Illinois, Chicago, USA

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

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

Stapled, linear

Page 23: Slawomir Marecik, MD, FACS, FASCRS Advocate Lutheran General Hospital, Park Ridge, IL Clinical Assistant Professor University of Illinois, Chicago, USA

Stapled, circular

Page 24: Slawomir Marecik, MD, FACS, FASCRS Advocate Lutheran General Hospital, Park Ridge, IL Clinical Assistant Professor University of Illinois, Chicago, USA
Page 25: Slawomir Marecik, MD, FACS, FASCRS Advocate Lutheran General Hospital, Park Ridge, IL Clinical Assistant Professor University of Illinois, Chicago, USA

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

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
Page 28: Slawomir Marecik, MD, FACS, FASCRS Advocate Lutheran General Hospital, Park Ridge, IL Clinical Assistant Professor University of Illinois, Chicago, USA
Page 29: Slawomir Marecik, MD, FACS, FASCRS Advocate Lutheran General Hospital, Park Ridge, IL Clinical Assistant Professor University of Illinois, Chicago, USA
Page 30: Slawomir Marecik, MD, FACS, FASCRS Advocate Lutheran General Hospital, Park Ridge, IL Clinical Assistant Professor University of Illinois, Chicago, USA

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

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

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

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

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

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
Page 37: Slawomir Marecik, MD, FACS, FASCRS Advocate Lutheran General Hospital, Park Ridge, IL Clinical Assistant Professor University of Illinois, Chicago, USA
Page 38: Slawomir Marecik, MD, FACS, FASCRS Advocate Lutheran General Hospital, Park Ridge, IL Clinical Assistant Professor University of Illinois, Chicago, USA
Page 39: Slawomir Marecik, MD, FACS, FASCRS Advocate Lutheran General Hospital, Park Ridge, IL Clinical Assistant Professor University of Illinois, Chicago, USA

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

Video – rectal cancer surgery Total mesorectal excision


Slawomir Nalecz, Ph. D. - ccss.jhu.edu

Complications During and After Restoration of Intestinal Continuity After Colostomy. Is it Worth it? Gustavo Plasencia, MD, FACS, FASCRS

Intensity of Post-Treatment Surveillance and …...INTENSITY OF POST-TREATMENT SURVEILLANCE AND SURVIVAL IN COLORECTAL CANCER PATIENTS George J. Chang, MD, MS, FACS, FASCRS Professor

TIBCO Integration - Slawomir Zak

Board review Manual - Hospital Physician · GeneRal SuRGeRy BoaRd Review Manual lower Gastrointestinal Bleeding Jennifer d. Silinsky, Md, david a. Margolin, Md, FaCS, FaSCRS, and

GEORGE E. THEODOROPOULOS, MD, PhD, FACS, FASCRS Associate Professor of Surgery… · 2020-01-31 · “Minimally Invasive Techniques in Colorectal Surgery” (Athens, 14.11.2014)

Digestive Disease Center Department of Colorectal Surgery Cleveland Clinic Feza H. Remzi MD, FACS, FASCRS Laparoscopy in Colorectal cancer: Where are we

Delayed GI Recovery Following Colectomy Anthony J. Senagore, MD, MBA, MS, FACS, FASCRS Vice President and Chief Academic Officer Spectrum Health Medical

T4 Colon Cancer and Laparoscopic Approach Gustavo Plasencia MD FACS, FASCRS Clinical Professor of Surgery Gustavo Plasencia MD FACS, FASCRS Clinical Professor

What to do with Anastomotic Stricture Gustavo Plasencia MD, FACS, FASCRS

FISSURE, FISTULA, AND ABSCESSES...FISSURE, FISTULA, AND ABSCESSES Elisa H. Birnbaum, MD, FACS, FASCRS, and Ira J. Kodner, MD, FACS, FASCRS Fissure An anal fi ssure is a small tear

"In Largul Marii" de Slawomir Mrozek

Morcellation of specimen : Fact or fiction? Gustavo Plasencia MD, FACS, FASCRS

Slawomir Marecik, MD, FACS Advocate Lutheran General Hospital, Park Ridge, IL Clinical Assistant Professor University of Illinois, Chicago, USA

Opening Remarks - Default | Doctors Hospital at … · Alberto Peña, MD, FACS, FASCRS . What is diarrhea? Osmotic • water drawn into bowel • bowel prep Secretory • body releases

It Takes a Team - cdn.ymaws.com · It Takes a Team …engaging frontline physicians to improve the journey across the continuum of care. Cedrek L. McFadden, MD, FACS, FASCRS Vice

Recurrent and Locally Advanced Rectal Cancer Surgery · Recurrent and Locally Advanced Rectal Cancer Surgery Scott R. Steele, MD, MBA, FACS, FASCRS Chairman, Department of Colorectal

Crohns colitis patients can be offerred an ileoanal pouch Feza H. Remzi, MD, FACS,FASCRS, FTSS ( Hon)Chairman Department of Colorectal Surgery Rupert B

Tips and Tricks of Avoiding and Management of Anastomotic Complications Feza H. Remzi, MD, FACS,FASCRS., FTSS (Hon)Chairman Department of Colorectal Surgery

Colorectal Cancer Update Jonathan A. Laryea, MD FACS FASCRS FWACS Division of Colon & Rectal Surgery Department of Surgery University of Arkansas for Medical

Perioperative anti-TNF biologics are not safe because they increase complications associated with surgery Feza H. Remzi FACS, FASCRS, FTTS ( Hon ) Chairman

Hand Assisted Surgery Bradley R. Davis, MD, FACS, FASCRS Associate Professor of Surgery Director Surgical Education/Surgical Skills Lab Program Director

Feza H. Remzi FACS, FASCRS, FTTS ( Hon ) Chairman Department of Colorectal Surgery

Board Certified Compassionate Surgical Care Tel: (954) 369-5717 …€¦ · 1 SW 129th Ave Suite 109 Pembroke Pines, FL 33027 Narciso L. Gomez, MD, FACS, FASCRS Board Certified in

Complications of Laparoscopic Surgery for Diverticulitis Bradley R. Davis, MD, FACS, FASCRS Associate Professor of Surgery University of Cincinnati

Surgical Treatment of the Low (Distal Third) Rectal Cancer Feza H. Remzi FACS, FASCRS, FTSS ( Hon ) Chairman Department of Colorectal Surgery Professor

Basics Skills for Laparoscopic Colon Surgery Bradley R. Davis, MD, FACS, FASCRS Associate Professor of Surgery University of Cincinnati Program Director

Gentler, Kinder Cut What’s New in Minimally invasive Colorectal Surgery? Samuel C. Oommen, MD, FACS, FASCRS Bay Area Colon and Rectal Surgeons Walnut Creek,

SILS Complications Dan Geisler, MD, FACS, FASCRS

Forging - Amazon Web Services - For… · Conor P. Delaney, MD, MCh, PhD, FrCsi, FaCs, FasCrs, is Chief, ... (poeM) technique for patients with dysphagia due to achalasia, as well

Implementation of NYSPFP Colon Surgery Bundle & SSI ......Implementation of NYSPFP Colon Surgery Bundle & SSI: Steps for Success David E. Rivadeneira, M.D., M.B.A., FACS, FASCRS Vice

Laparoscopic Versus Open Colectomy: Case Selection and Techniques Anthony J. Senagore, MD, MBA, MS, FACS, FASCRS Vice President and Chief Academic Officer

Memorial Sloan Kettering Cancer Center Columbia University ...€¦ · SPANISH AMERICAN MEDICAL AND DENTAL SOCIETY OF NEW YORK José G. Guillem, MD, MPH, FACS, FASCRS President, Spanish

Slawomir Mrozek's The Police

In Largul Marii Slawomir Mrozek OK