Surgical mortality in patients in extremis: futility in emergency abdominal surgery

Key Questions

1. What is laparoscopic surgery?

Laparoscopic surgery is a minimally invasive surgical technique that uses small incisions and specialized instruments to perform procedures, including right hemicolectomy. This review focuses on mesenteric closure after laparoscopic right hemicolectomy.

2. How long does laparoscopic surgery take?

While this review does not specifically address surgery duration, it notes that mesenteric closure can prolong operation time, which is one reason it is not recommended as a routine procedure after laparoscopic right hemicolectomy.

3. What are the benefits of laparoscopic surgery?

The review mentions that laparoscopy is commonly used in colorectal surgery due to advantages over open surgery, though it does not elaborate on specific benefits.

4. How much does laparoscopic surgery cost?

This review does not discuss the costs associated with laparoscopic surgery or mesenteric closure procedures.

5. What is mesenteric closure in laparoscopic right hemicolectomy?

Mesenteric closure is the process of closing defects in the mesentery created during laparoscopic right hemicolectomy. It may potentially prevent internal hernias caused by the small intestine passing through these defects.

6. Does mesenteric closure reduce complications after laparoscopic right hemicolectomy?

The review found no significant differences in postoperative complications or reoperation rates between patients who had mesenteric closure and those who did not after laparoscopic right hemicolectomy.

7. What tools are used for mesenteric closure in laparoscopic right hemicolectomy?

The review discusses several tools for mesenteric closure, including polymer ligating clips, barbed sutures, and non-absorbable sutures. Polymer ligating clips showed promising results in a small trial.

8. Is routine mesenteric closure recommended after laparoscopic right hemicolectomy?

Based on current evidence, the review concludes that mesenteric closure cannot be recommended as a routine procedure after laparoscopic right hemicolectomy, primarily due to the prolongation of operation time.

Summary Video Not Available