Laparoscopic Colorectal Cancer Surgery by Makio Mike

Author:Makio Mike
Language: eng
Format: epub
Publisher: Springer Singapore, Singapore

At the medial part, the procedure continues with the dissection of the caudal tissue from the ventral side of Denonvilliers’ fascia. In other words, this is achieved by entering between the dorsal side of the deep subperitoneal fascia and the Denonvilliers’ fascia. Without continuing to dissect on both sides, it is important to dissect the median in order to reveal the inner sides of the bilateral seminal vesicles (Fig. 4.12). The dissection continues between the dorsal side of the seminal vesicle and Denonvilliers’ fascia. If the seminal vesicle is confirmed to be covered with the deep subperitoneal fascia, it is not to be mistaken for the dissecting layer. Following careful haemostasis of the small veins from the cranial and lateral side of the seminal vesicles, the dissection can continue towards the caudal side. It is better to dissect the Denonvilliers’ fascia caudally as far as possible. There are visible dents indicating the passage to the supralevator space along the bilateral side of the rectum.

Fig. 4.12Dissection between Denonvilliers’ fascia and the deep subperitoneal fascia. At the medial part, the procedure requires to continue the dissection caudally along the dorsal side of the deep subperitoneal fascia from the ventral side of Denonvilliers’ fascia. If the seminal vesicle is confirmed covered by the deep subperitoneal fascia, it is not to be mistaken for the dissecting layer

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