Visualization of surgical anatomy : digestive organns with special reference to lymphatics

对于胃肠道器官的癌症手术，有两个重要但相反的因素需要考虑：根治性切除和功能保留。由于两者对于实现真正成功的、可操作的结果至关重要，因此必须巧妙地将两者结合起来。为了开发新的综合外科策略，了解消化道局部解剖的细节以及与消化器官的复杂关系至关重要。由于很少有报道包括这些复杂的关系的实际解剖介绍，我们进行了详细的解剖的特殊器官，特别是它们与植物神经和内脏筋膜的关系，为外科手术参考，这些有价值的发现是专业的视频记录和编辑，用日语和英语叙述。这些视频目前在日本各地以及国外的外科医生中使用。在第一年，解剖视频 关于我们 着重于腹主动脉周围的血管及其与主动脉自主神经丛的关系。特别是，视频说明了下行路径（从上腹部器官）和上行路径（从盆腔器官）在肾血管水平的会聚模式，以形成胸导管。第二年，解剖的基础是从盆腔内脏器官到髂淋巴结的外侧分支，包括1）盆腔丛的组成和2）分支，以及3）这些器官的内脏筋膜。上述三个相互关系的几何学清楚地描述和显示。在第三年，重点是对transchea和食管周围的解剖学，包括静脉角的会聚方式和与周围结构的关系。这种消化器官解剖学的可视化似乎对外科医生开发新的根治性手术技术与最终功能保留相结合是有用的。少

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 … More 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