This is how we peritoneal malignancy surgeons like to spend 13 hrs of a day....https://abs.twimg.com/emoji/v2/... draggable="false" alt="😉" title="Zwinkerndes Gesicht" aria-label="Emoji: Zwinkerndes Gesicht">
Getting started: assess the extent of the peritoneal disease and make a plan for the resections that will be needed
In this case of #mesothelioma: extensive disease on all parietal and visceral peritoneum : showing here mesentery of colon)
All of Small bowel:
Pelvis: confluence of disease with inability to visualize rectum, uterus and ovaries
Summary: PCI 37 BUT no infiltrative growth and almost no involvement of the serosa of the SB —> complete cyto reduction achievable. Time to get to work-let’s do this
Starting to make progress: R diafragm done
Keep going: left diagram, omentectomy, splenectomy and lesser omentectomy done
Keep going: left diagram, omentectomy, splenectomy and lesser omentectomy done
Keep going: left diagram, omentectomy, splenectomy and lesser omentectomy done
We’re all warmed up now-time to get the pelvis done: en block peritonectomy w rectosigmoid rx and hist-BSO
Teamwork is everything!@IsabelRamosMD @dr_oriol We are not tired yet...there ‘s still all that visceral peritoneum waiting ...
Tedious work... but can be done. Compare and contrast cleaned up section with non- done section ( final 40cm of ileum that will be resected with R colectomy)
Tedious work... but can be done. Compare and contrast cleaned up section with non- done section ( final 40cm of ileum that will be resected with R colectomy)
Tedious work... but can be done. Compare and contrast cleaned up section with non- done section ( final 40cm of ileum that will be resected with R colectomy)
.... finally.... all the resections ( and recons) are done ... time for HIPEC! https://abs.twimg.com/emoji/v2/... draggable="false" alt="đŸ”„" title="Feuer" aria-label="Emoji: Feuer">https://abs.twimg.com/emoji/v2/... draggable="false" alt="đŸ”„" title="Feuer" aria-label="Emoji: Feuer">
Hour 13: back in for a check, confirm excellent hemostasis, look at anastomoses ( 2 in this case-ileocolic and colorectal, no ostomies), place drains
Hour 13: back in for a check, confirm excellent hemostasis, look at anastomoses ( 2 in this case-ileocolic and colorectal, no ostomies), place drains
Hour 13: back in for a check, confirm excellent hemostasis, look at anastomoses ( 2 in this case-ileocolic and colorectal, no ostomies), place drains
Great work by our anesthesia team- pt goes stable to the ICU. And we go home to sleep https://abs.twimg.com/emoji/v2/... draggable="false" alt="😮" title="Schlafendes Gesicht" aria-label="Emoji: Schlafendes Gesicht"> https://abs.twimg.com/emoji/v2/... draggable="false" alt="😮" title="Schlafendes Gesicht" aria-label="Emoji: Schlafendes Gesicht"> Let’s do it all over again tomorrow https://abs.twimg.com/emoji/v2/... draggable="false" alt="😆" title="LĂ€chelndes Gesicht mit geöffnetem Mund und fest verschlossenen Augen" aria-label="Emoji: LĂ€chelndes Gesicht mit geöffnetem Mund und fest verschlossenen Augen">
Peritoneal mesothelioma is rare and difficult to treat but CRS and #HIPEC is a powerful tool to fight it @RENAPE_Network @FaheezM @kturaga @hralexander_MD @Mesouk @curemeso @indepso @oliviawriting #PaulSugarbaker
You can follow @LanaBijelicMD.
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