Research Abstract |
For cancer surgery of the gastrointestinal organns, there are two important although opposing factors to consider : radical dissection, function preservation. As both are critical to achieve truly successful, operative outocome, both must be skillfully integrated. In order to develop new comprehensive surgical strategies, it is critical to understand the minute details of the regional anatomy of the lymphatics and the complex relationships to the digestive organs. As there are few reports including actual dissection presentation of these complicated relationships, we performed detailed dissecrion of lymphatics of special organs with special reference to their relatinship to the autonomic nerves and visceral fasciae, For surgical reference, these valuable findings were professionally recorded on video and edited, with narration in both Japanese and English languages. These videos are currently in use by surgeons throughout Japan, as well as abroad. In the first year, the dissection vide
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o focused on the lymphatics surrounding the abdominal aorta and the relation to the aoritic autonomic plexus. In particular, the video illustrates the mode of convergence of the descending pathway (from the upper abdominal organs) and the ascending pathway (from the pelvic organs) at the level of the renal vessels to form the thoracic duct. In second year, the dissection was based of the lateral lympahatics from the pelvic internal organs to the iliac nodes, including the 1) composition and 2) ramification of the pelvic plexus, as well as 3) the visceral fascia of these organs. The interrelationships of the above three with the lymphatics were clearly described and shown. In the third year, the emphasis was on the lymphatics surrounding the tranchea and esophagus, including the mode of covergence to the venous angle and the relationships to the surrounding structures. This visualization of the digestive organ lymphatics appears to be useful for surgeons for the development of new surgical techniques for radical operations harmoniously combined with ultimate function preservation. Less
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