Membrane anatomy: motivation to promote precise laparoscopic and robot colorectal surgery / 中华胃肠外科杂志

ABSTRACT

During the past 20 years, the development of minimally invasive surgery had developed through three stages organ excision, radical organ excision centered on arteries and functional radical organ excision based on membrane anatomy.While high-definition laparoscopy was gaining more popularity, surgeons gradually observed the fascial spaces and fascial structures which could not be recognized by naked eye during open surgery. With the development of membrane anatomical architecture, we discovered several fascial spaces and fascial structures that had never been recognized before. Inspired with the anatomical concept, proposed by Professor Gong Jianping, we systematically observed and expounded the laparoscopic radical surgery for colorectal cancer based on membrane anatomy, and explored the fascial anatomy structure and fascial space during operations for right semicolon, left semicolon and rectum through the high-definition visualization of the endoscope and robot in combination with clinical practice. Meanwhile, the membrane anatomy theory was systematically studied through repeated surgical operations and verified through practice. The fascial anatomy structures, such as "space between small intestine and ascending mesentery", "transverse mesocolon radix" and "terminal line of total mesorectal excision" were proposed. This theory can promote the stable development of "microbleeding" or "no blood" minimally invasive colorectal surgery.