1. Slawomir Marecik, MD, FACS, FASCRS Advocate Lutheran General Hospital, Park Ridge, IL Clinical Assistant Professor University of Illinois, Chicago, USA

2.  Anatomy  Colon cancer  Rectal cancer  Diverticular disease  Inflammatory bowel disease  Crohn’s disease  Ulcerative colitis

3.  How long is your colon?

4.  picture of the colon  lymph nodes  vessels  retroperitoneal part  perforations

13.  video full colon inside live

14.  video of right colon specimen  video of left colon and rectum specimen

15.  pictures right colon  transverse  left colon  sigmoid

18.  type of operations  type of anastomosis  how the anastomosis is created  stapling

20.  Hand-sewn  Stapled  Linear stapler  Circular stapler

25.  When is colostomy needed?  emergency situation when…  bowel is not prepared (bowel prep)  patient has no healing potential  poor nutrition  poor vascular supply  steroids, other severe conditions

26.  Anatomy  mesorectum, valves, lymph nodes  sphincter

30.  Level of tumor

31.  Type of operations  endoscopic excision  local (transanal) excision  radical surgery (involving bowel and lymph nodes)  radical surgery with sphincter

32. ANTERIOR RESECTION ULTRALOW ANTERIOR RESECTION LOW ANTERIOR RESECTION COLOANALPULLTHROUGH

33.  When is colostomy needed?  tumor involving the sphincter  poor preoperative continence  When is (protective) ileostomy needed?  low pelvic anastomosis  if radiation was given before surgery

34.  Need for proper evaluation  endoscopy  ultrasound  MRI

35.  Straight connection  J pouch  Side to end  video

39.  preoperative chemoradiation therapy  when?  how long?  why ileostomy?  why pouchogram and flex sig?

40.  Video – rectal cancer surgery  Total mesorectal excision