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Laparoscopic proctocolectomy with ileal pouch-anal anastomosis is indicated most commonly for ulcerative colitis and familial adenomatous polyposis. Antibiotics, steroids if indicated, and DVT prophylaxis are used preoperatively. The patient is carefully positioned after induction of general anesthesia. Four port sites, one of which is the planned ileostomy site, are selected. Proctocolectomy proceeds with sigmoid, descending, ascending, and transverse mobilization. This is followed by rectal dissection with transection at the level of the pelvic floor, then mesenteric transection, exteriorization, and resection at the terminal ileum with preservation of the ileocolic pedicle. A 15-cm pouch is fashioned, a stapled anastomosis is created at the top of the anal sphincter, and a proximal loop ileostomy is formed. Patients are advanced from clear liquids to solids by postoperative day (POD) 2, and are discharged between PODs 3 and 4. Potential complications include ureteral injury, ileus, bowel obstruction, high output ileostomy, and pouch leak. Patients can expect to have four to six bowel movements per day after closure of the loop ileostomy, and satisfaction is generally high.


A new species of triplefin fish (Blenniiformes: Tripterygiidae), Helcogramma williamsi, is described from six specimens collected from southern Taiwan. This species is well distinguished from its congeners by possessing 13 second dorsal-fin spines; third dorsal-fin rays modally 11; anal-fin rays modally 19; pored scales in lateral line 22-24; dentary pore pattern modally 5+1+5; lobate supraorbital cirrus; broad, serrated or palmate nasal cirrus; first dorsal fin lower in height than second; males with yellow mark extending from anterior tip of upper lip to anterior margin of eye and a whitish blue line extending from corner of mouth onto preopercle. Comparisons and a diagnostic key are provided for the species of Helcogramma now known from Taiwan: Helcogramma fuscipectoris, Helcogramma inclinata, Helcogramma striata, Helcogramma trigloides, and the newly recorded, Helcogramma rhinoceros.


The genus Helcogramma McCulloch & Waite (1918) contains small to medium sized tripterygiid fishes with rather fusiform bodies. It can be distinguished from other genera of Tripterygiidae by the following combination of features: a single continuous lateral line; first dorsal fin with three spines; anal fin with a single spine; pelvic fin with one hidden spine and two simple rays (Rosenblatt 1960; Fricke 1997). Species of the genus Helcogramma share the following characters: lateral line with 12-37 pored scales, curving ventrally from the posttemporal to mid-body and extending to below the second or third dorsal fin or onto caudal peduncle; spine of anal fin usually less than half the length of first ray; the two segmented rays of pelvic fin sometimes joined by membrane for part of their length; dentary canals with 1-7 pores at the symphysis and 2-10 on either side; supraorbital cirrus simple to palmate or absent; nasal cirrus simple to palmate. Body with ctenoid scales; nape usually naked, rarely with a few scales; head, abdomen and pectoral-fin base always naked (Hansen 1986; Shen and Wu 1994; Fricke 1997; Holleman 2007).


Counts and measurements follow those given by Holleman and Bogorodsky (2012) and Chiang and Chen (2008). Measurements were made with needle-point calipers under a dissecting microscope and recorded to the nearest 0.1 mm. Proportional measurements given in the text are in relation to standard length (SL), head length (HL) and eye diameter. Meristic abbreviations include A = anal-fin rays and D = dorsal-fin rays. Elements of the three dorsal fins are presented as a formula: number of spines in first dorsal fin, number of spines in second fin, number of segmented rays in third fin. Dentary pore counts are listed as a formula: right dentary + symphyseal + left dentary. Osteological observations were made on cleared and stained specimens and from radiographs. Number of vertebrae represented as precaudal + caudal vertebrae following Holleman (1982).


The new species can be distinguished from congeners by the following combination of features. Second dorsal-fin spines XIII; third dorsal-fin rays modally 11; anal-fin rays modally 19; lateral line with 22-24 pored scales; pattern of dentary pores modally 5+1+5; nape naked; supraorbital cirrus lobate; nasal cirrus broad, serrated or palmate; first dorsal fin lower in height than second; males with yellow mark from anterior tip of upper lip to anterior margin of eye and a whitish blue line extending from corner of mouth onto preopercle.


D III, XIII-XIV (holotype: XIII), 10-11 (holotype: 11). A I, 19-20 (holotype: 19). Pectoral fin rays 1+8+7, uppermost ray simple, eight middle rays branched, seven lowermost rays simple. Pelvic fin I, 2, rays united by membrane for half the length of shorter ray. Caudal fin rays 2+9+2, two uppermost and lowermost rays simple, nine middle rays branched. Scale rows 36-37. Lateral line with 22-24 (holotype: 24) pored scales, ending below 2nd-4th ray of third dorsal fin. Patterns of cephalic sensory canal pores are illustrated in Fig. 2. Dentary with a single symphyseal pore, dentary pore pattern 5-6+1+5-6 (holotype: 5+1+5). Vertebrae 10+26. No free pterygiophore between second and third dorsal fins.


Body moderately elongate and compressed. Head moderately large, dorsal profile triangular. Body covered with ctenoid scales. Head, nape, base of pectoral fin, and abdomen naked; body scales not extending to bases of first and anterior portion of second dorsal fins. Mouth terminal, posteriormost margin of maxilla just reaching vertical through anterior margin of pupil. Eye moderately large and slightly angled dorsally. Supraorbital cirrus lobate, usually with micromelanophores. Anterior nostril a short tube with broad, serrated or palmate nasal cirrus. First dorsal fin lower in height than second in both sexes. Anal fin beginning below vertical through base of 7th or 8th spine of second dorsal fin; pectoral fin large and pointed, posterior tip of longest ray below last spine of second dorsal fin; caudal fin truncate to slightly rounded. Morphometric data are listed in Table 1.


Cephalic sensory canal system of Helcogramma williamsi sp. n., holotype, NTOU-P 201202-002, male, 27.5 mm SL a Dorsal view b Lateral view c Ventral view. Canal system indicated in gray. Scale bar = 1 mm.


Helcogramma williamsi shares the pattern of dentary pores and the numbers of fin rays and lateral-line scales with three congeners: Helcogramma capidataRosenblatt (1960), Helcogramma alkamrHolleman (2007), and Helcogramma rharhabeHolleman (2007).These four species, as well as others in the Helcogramma obtusirostris species group, also share a putative synapomorphy- a blue line running from the corner of the mouth onto the preopercle in mature males.


However, Helcogramma williamsi is distinguished from Helcogramma capidata by its lobate supraorbital cirrus vs. without supraorbital cirrus; upper jaw extending to a point below anterior half of eye vs. extending to a point below posterior half of eye; and moderately complex cephalic sensory canal pores vs. rather simple pore pattern. Helcogramma williamsi can bedistinguished from Helcogramma rharhabe by the following features: vertebrae 10+26 vs. 10+24-25; males with yellow mark from anterior tip of upper lip to anterior margin of eye vs. crimson marks on upper lip on either side of center, black in the centre; body with 5-6 pairs of indistinct semi-bars vs. body of males almost entirely black with 3-4 pale narrow streaks from dorsum to midline. Helcogramma williamsi seems to be more similar to Helcogramma alkamr than to any other congeneric species in overall pattern of colouration. However, it can be distinguished from Helcogramma alkamr by the following features: height of first dorsal fin more than half height of second dorsal fin vs. height of first dorsal fin less than half height of second dorsal fin; lateral-line scales extending to a point below insertion between 2nd-4th rays of third dorsal fin vs. lateral-line scales extending to a point just below the junction of second and third dorsal fins; ventral side of caudal peduncle with cycloid scales vs. ventral side naked; iris orange-red with reddish brown ring vs. red and pale gold. 041b061a72


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