Table Of ContentLANDES V a d e m e c u m BL LANDES V a d e m e c u m
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BIOSCIENCE BIOSCIENCE
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Table of contents (excerpt) CES Endosurgery
V
1. Surgical Oncology: Role of Video 10. Laparoscopy and Gastric Cancer:
a
Laparoscopy Perspective and Controversies
d
2. Physiologic Alterations Associated 11. Hand-Assisted Laparoscopic e for Cancer
with Laparoscopy Gastrectomy m
3. Laparoscopic Diagnosis and Treatment 12. Laparoscopic Adrenal Surgery e
of Ascites and Peritoneal Malignancies c
13. Videolaparoscopy in Kidney Tumors
4. Lymphoma Staging: Basic Features u
14. Laparoscopic Surgery in Kidney Cancer m
5. Laparoscopic Management of Lymphomas
15. Endosurgery and Pediatric Oncology
6. Videolaparoscopy and Pancreatic Cancer E
16. Complications of Videolaparoscopy n
7. Laparoscopic Assessment of Tumors d
17. Role of Laparoscopic Ultrasound in
of the Pancreatic Head o
Minimal Access Surgery: Overview
s
8. Laparoscopy in the Diagnosis and u
Treatment of Hepatobiliary Malignancies 18. Biology of Videothoracoscopy r
g
9. Laparoscopic Treatment of Colorectal 19. Video-Assisted Thoracic Surgery for e
Lung Cancer r
Malignancies y
f
o
This is one of a new series of medical handbooks. r
C
It includes subjects generally not covered in other handbook series, especially
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many technology-driven topics that reflect the increasing influence of technology
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in clinical medicine.
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a Latin word that roughly means “to carry along”. In the Middle Ages, traveling r
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v a d e m e c u m
Endosurgery for Cancer
Steve Eubanks, MD
Duke University
Ricardo V. Cohen, MD
University of São Paulo
Riad N. Younes, MD, PhD
University of São Paulo
Fredrick Brody, MD, PhD
Cleveland Clinic
L A N D E S
B I O S C I E N C E
AUSTIN, TEXAS
U.S.A.
VADEMECUM
Endosurgery for Cancer
LANDES BIOSCIENCE
Austin
Copyright © 1999 Landes Bioscience
All rights reserved.
No part of this book may be reproduced or transmitted in any form or by any
means, electronic or mechanical, including photocopy, recording, or any
information storage and retrieval system, without permission in writing from
the publisher.
Printed in the U.S.A.
Please address all inquiries to the Publisher:
Landes Bioscience, 810 S. Church Street, Georgetown, Texas, U.S.A. 78626
Phone: 512/ 863 7762; FAX: 512/ 863 0081; www.landesbioscience.com
ISBN: 1-57059-525-9
Library of Congress Cataloging-in-Publication Data
Endosurgery for cancer / Steve Eubanks… [et al.].
p. cm.
"Vademecum"
Includes bibliographical references and index.
ISBN 1-57059-525-9 (alk. paper)
1. Cancer--Endoscopic surgery. 2. Laparoscopic surgery.
3. Abdomen--Endoscopic surgery. I. Eubanks, Steve, 1959-
DNLM: 1. Neoplasms--surgery. 2. Surgical Procedures, Endo-
scopic--methods. 3. Video Recording. QZ 268 E56 1999]
RD651.E53 1999
616.99'4059--DC21
DNLM/DLC 99-10906
for Library of Congress CIP
While the authors, editors, sponsor and publisher believe that drug selection and dosage
and the specifications and usage of equipment and devices, as set forth in this book, are in
accord with current recommendations and practice at the time of publication, they make
no warranty, expressed or implied, with respect to material described in this book. In
view of the ongoing research, equipment development, changes in governmental regula-
tions and the rapid accumulation of information relating to the biomedical sciences, the
reader is urged to carefully review and evaluate the information provided herein.
Dedication
To Carol, Gui and Regina; reasons for my efforts.
Ricardo Cohen
To Michael E. Burt, MD, PhD
Riad Younes
To Sandy, Alicia, Bethany, and Austin; with gratitude for
your constant love and support.
Steve Eubanks
Contents
1. Surgical Oncology: Role of Videolaparoscopy....................1
Yoshikazu Noguchi, Kuniyasu Fukuzawa, Takiki Yoshikawa,
Riad N. Younes
Introduction..................................................................................................1
Principles of Oncologic Surgery...................................................................4
Role of Laparoscopy in Oncological Surgery...............................................5
Future Directions........................................................................................18
2. Physiologic Alterations Associated with Laparoscopy ....28
Martin J. Heslin and Paul Armstrong
Introduction................................................................................................28
Cardiovascular and Hemodynamic............................................................28
Mode of Abdominal Expansion .................................................................29
Type of Gas Utilized....................................................................................30
Laparoscopy in the Compromised Host....................................................31
Visceral Alterations.....................................................................................32
Neurologic Changes....................................................................................33
Endocrine Metabolic Effects.......................................................................34
3. Laparoscopic Diagnosis and Treatment of Ascites
and Peritoneal Malignancies .............................................37
Frederick L. Greene
Diagnosis and Work-up of Malignant Ascites...........................................39
Patient Selection and Technique ................................................................41
Laparoscopy for Ascites and Peritoneal Malignancy–Results...................44
4. Lymphoma Staging: Basic Features...................................47
Jacques Tabacof, Ricardo V. Cohen, Aldo J. Rodrigues Jr.
Hodgkin’s Disease (HD) Staging................................................................47
Operative Procedure...................................................................................48
Non-Hodgkin’s Lymphoma Staging ..........................................................48
5. Laparoscopic Management of Lymphomas......................49
Jeffrey A. Travis, Frederick L. Greene
Introduction................................................................................................49
Hodgkin’s and Non-Hodgkin’s Lymphoma...............................................49
Surgical Management .................................................................................50
Laparoscopic Staging of Abdominal Lymphomas.....................................52
6. Videolaparoscopy and Pancreatic Cancer.........................57
Kevin C. Conlon, Murray F. Brennan
Introduction................................................................................................57
Rationale for Laparoscopic Staging............................................................58
Memorial Sloan-Kettering Experience.......................................................59
Laparoscopic Biliary and Gastric Bypass...................................................62
Conclusion...................................................................................................66
7. Laparoscopic Assessment of Tumors
of the Pancreatic Head .......................................................70
Miguel A.Cuesta, Paul J. Borgstein, S. Meijer
Introduction................................................................................................70
Diagnostic Laparoscopy..............................................................................71
Conclusions.................................................................................................73
8. Laparoscopy in the Diagnosis and Treatment
of Hepatobiliary Malignancies..........................................75
Paul J. Borgstein, Miguel A. Cuesta, S. Meijer
Introduction................................................................................................75
Surgery of Hepatobiliary Malignancies .....................................................76
Radiological Imaging Modalities................................................................78
Intraoperative Ultrasonography (IOUS)...................................................80
Laparoscopic Ultrasonography (LUS).......................................................81
Therapeutic Laparoscopy (Minimally Invasive Surgery)..........................99
Conclusions...............................................................................................102
9. Laparoscopic Treatment of Colorectal Malignancies ....107
Morris E. Franklin Jr. and Jorge Balli
Introduction..............................................................................................107
Technique of Laparoscopic Colon Resection...........................................108
Technique of Laparoscopic Colon Surgery, Patient Selection.................108
Operative Procedure.................................................................................109
Conclusions...............................................................................................110
10. Laparoscopy and Gastric Cancer:
Perspective and Controversies.........................................112
Demetrius E.M. Litwin, Peter C. Willsher
Introduction..............................................................................................112
Laparoscopic Approach to Gastric Cancer..............................................112
Laparoscopic Staging of Gastric Cancer..................................................114
Operative Procedure, Preoperative Considerations,
Patient Evaluation.....................................................................................115
Operative Technique.................................................................................116
Postoperative Care.....................................................................................121
Conclusion.................................................................................................121
11. Hand-Assisted Laparoscopic Gastrectomy.....................124
John J. Kelly, Andras Sandor, Demetrius E.M. Litwin
Introduction..............................................................................................124
Patient Selection........................................................................................125
Patient Preparation and Positioning........................................................125
Hand-Assist Placement.............................................................................126
Subtotal Gastrectomy................................................................................129
Total Gastrectomy.....................................................................................132
Postoperative Management......................................................................137
Summary...................................................................................................139
12. Laparoscopic Adrenal Surgery.........................................140
Sonia L. Sugg, Demetrius Litwin
Introduction..............................................................................................140
Preoperative Evaluation............................................................................140
Indications for Surgery.............................................................................142
Surgical Techniques...................................................................................145
Summary...................................................................................................149
13. Videolaparoscopy in Kidney Tumors..............................152
Anuar I. Mitre, Lísias N. Castilho
Introduction..............................................................................................152
Patient Selection........................................................................................153
Patient Preparation...................................................................................153
Radical Nephrectomy................................................................................153
Partial Nephrourectomy...........................................................................158
Partial Nephrectomy and Renal Wedge Resection...................................159
Conclusion.................................................................................................159
14. Laparoscopic Surgery in Kidney Cancer.........................163
Luciano J. Nesrallah, Miguel Srougi
Operative Technique.................................................................................164
Clinical Experience....................................................................................165
Conclusion.................................................................................................166
15. Endosurgery and Pediatric Oncology.............................168
Paulo Chapchap, Ricardo F.C. da Rocha
The Surgeon’s Role in Pediatric Oncology...............................................168
Pediatric Endosurgery...............................................................................168
Diagnosis, Staging and Tissue Sampling..................................................170
Evaluation and Resectability.....................................................................171
Other Indications......................................................................................172
Contraindications of Pediatric Endosurgery...........................................174
Future Perspectives....................................................................................174
16. Complications of Videolaparoscopy...............................177
Nilton T. Kawahara, Ricardo V. Cohen, Riad N. Younes,
Aldo J. Rodrigues Jr.
17. Role of Laparoscopic Ultrasound
in Minimal Access Surgery: Overview.............................179
Ramachandia Kolachalam, Maurice E. Arregui
Introduction..............................................................................................179
Indications for Laparoscopic Ultrasound................................................180
Technique ..................................................................................................180
Pancreas.....................................................................................................182
Role of LUS in Intra-abdominal Malignancy: Results............................184
Pancreatic-Biliary-(Malignant Group)....................................................186
Pancreas-Benign Group............................................................................187
Liver Malignant Group.............................................................................187
Liver-Benign Group..................................................................................187
Colon Cancer Staging...............................................................................188
Unknown Primary....................................................................................188
Stomach, Spleen and Adrenals..................................................................192
Miscellaneous............................................................................................192
Summary...................................................................................................192
18. Biology of Videothoracoscopy.........................................194
Jefferson L. Gross, Riad N. Younes
Introduction..............................................................................................194
Port Site Recurrence..................................................................................194
Pathophysiology of Tumor Implants.......................................................195
Acute Pain..................................................................................................196
Chronic Pain..............................................................................................196
Immune Response.....................................................................................197
19. Video-Assisted Thoracic Surgery for Lung Cancer........199
Riad N. Younes
20. VATS in Malignant Pleural Disease.................................204
Riad N. Younes
Technique of VATS for Pleural Disease....................................................205
Pleurodesis.................................................................................................205
Mesothelioma............................................................................................206
21. Laparoscopic Approach to Esophageal Cancer...............208
Eugênio A.B. Ferreira, Fábio de Oliveira Ferreira
Introduction..............................................................................................208
Technical Aspects ......................................................................................208
Surgical Access and Technical Aspects.....................................................209
Esophagectomy by Video-thoracoscopy (EVT).......................................209
Critical Analysis.........................................................................................213
Technical Modalites of Video-assisted Esophagectomy..........................215
22. Videoendoscopy for Mediastinal Cysts and Tumors......218
Anthony P.C. Yim, Anthony T.C. Chan, M. Bashar Izzat
Introduction..............................................................................................218
Roles of Videothoracoscopy.....................................................................220
Surgical Techniques and Strategies...........................................................221
Thymectomy..............................................................................................223
Mediastinal Cystectomy............................................................................223
Resection of Neurogenic Tumors.............................................................224
Mediastinal Mass Biopsy...........................................................................226
Conclusion.................................................................................................226
23. Video-Assisted Thoracic Surgery
for Malignant Pericardial Effusion..................................228
Allen L. Davies
Patient Selection........................................................................................228
Anesthetic and Surgical Technique of VATS Pericardiectomy................229
The Author’s Experience...........................................................................230
Summary...................................................................................................231
24. Complications in Video-Assisted Thoracoscopy............233
Riad N. Younes
Index..................................................................................237
Editors
Steve Eubanks, MD
Assistant Professor of Surgery
Director of Surgical Endoscopy
Director of the Duke/U.S. Surgical Endosurgery Center
Duke University
Ricardo V. Cohen, MD
Albert Einstein Hospital
University of São Paulo
São Paulo, Brazil
Chapters 4, 16, 18
Riad N. Younes, MD, PhD
Department of Surgery
University of São Paulo, School of Medicine
Department of Thoracic Surgery
Hospital do Cancer AC Camargo
University of São Paulo
São Paulo, Brazil
Chapters 1, 16, 21, 18, 20, 21, 22, 26
Fredrick Brody, MD
Assistant Professor of Surgery
Cleveland Clinic Foundation
Minimally Invasive Surgery Center
Cleveland, Ohio
Contributors
Maurice E. Arregui, MD Paul J. Borgstein, MD
St. Vincent Hospital Department of Surgical Oncology
Indianapolis, Indiana, USA Academic Hospital, Vrije Universiteit
Chapter 17 Amsterdam, The Netherlands
Chapters 7,8
Paul Armstrong, MD
Resident in Surgery Murray F. Brennan, MD, FACS
Division of General Surgery Professor of Surgery and Chairman
University of Alabama at Birmingham Department of Surgery
Birmingham AL, USA Memorial Sloan-Kettering Cancer Center
Chapter 2 New York, New York, USA
Chapter 6
Jorge Balli, MD
Texas Endoscopy Institute
San Antonio, TX, USA
Chapter 9
