LAPAROSCOPY FOR CROHN’S DISEASE




Step 1: Surgical Anatomy





  • None.





Step 2: Preoperative Considerations





  • The most common laparoscopic resection for Crohn disease is unquestionably ileocecal resection. The conduct and intraoperative steps vary depending on presentation and intraoperative findings. The medial to lateral approach described below is typically used with two notable exceptions:




    • Thickened mesentery. If the mesentery is very bulky and difficult to handle laparoscopically, bleeding can be profuse when attempting to divide the ileocolic pedicle. In these cases the entire mobilization is performed, but the vascular pedicle is safely taken extracorporeally.



    • Mesenteric phlegmon/abscess. In the setting where the mesentery is occupied by a large abscess or phlegmon a lateral to medial approach is appropriate.






Step 3: Operative Steps



Routine Ileocecal Resection



Mar 13, 2019 | Posted by in GASTROENTEROLOGY | Comments Off on LAPAROSCOPY FOR CROHN’S DISEASE
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