Transillumination Instrument Facilitates Faster and More Accurate Dissection of Right Colon Segment for Oesophageal Reconstruction

Abstract

Venous insufficiency of a right colon interposition in oesophageal reconstruction can be a fatal complication. The right colon segment could allow restoration of swallowing and speech in reconstruction of the entire oesophagus. The right colon segment is a good choice because of the large middle colic artery and isoperistaltic direction. However, because of the anatomical variation of the veins and the tiny venous network of the right colon, its success rate is lower compared with that of the left colon segment. Therefore, we devised a simple instrument of transillumination that can provide an improved view during surgery of the venous network of the right colon and ileocecal region when dissecting this important structure. Methods: Thirty-six patients underwent oesophageal reconstruction with a right colon segment using the instrument. The instrument of transillumination was used in all cases while exploring the pedicle vessels and the venous network of the right colon. Results: No patients developed complications related to the use of the instrument. Conclusion: The instrument of transillumination is a simple and useful tool for facilitating dissection of the right colon segment. In the future, the technique could be used for all types of bowl dissection.

Keywords

• obesity
• oesophageal reconstruction
• right colon segment
• transillumination
• vascular pedicle