Specimen Extraction for Very Low Tumors and Handsewn Coloanal Anastomosis KEY STEPS 1. Intersphincteric dissection is completed from below. 2. Specimen extracted transanally or through ostomy site. 3. Handsewn coloanal…
Stapled Coloanal and Colorectal Anastomoses KEY STEPS 1. Exteriorization and resection of the pathology. 2. Insertion of the EEA stapler anvil in the proximal colon using a purse-string suture. 3….
Division of the Upper and Lower Rectum Division of the rectosigmoid junction and mesorectum are performed during sigmoid and low anterior resections. This section concentrates on the rectal division; for…
Mobilizing the Mesorectum Mobilization of the mesorectum is performed in low anterior resection, abdominoperineal resection, and total proctocolectomy cases. KEY STEPS 1. Insertion of ports: 10-mm umbilical Hasson technique; 12…
Mobilization of the Splenic Flexure Splenic flexure mobilization may be performed during low anterior resection, sigmoid colectomy, left colectomy, or total colectomy. In this chapter, we concentrate on the lateral…
Hepatic Flexure Mobilization Mobilization of the hepatic flexure is performed for right colectomy, total colectomy, and total proctocolectomy. Details of the hepatic flexure mobilization are incorporated in the operative steps…
Ileocolic Artery Ligation KEY STEPS 1. Insertion of ports: 10-mm umbilical Hasson technique; 5-mm left iliac fossa; 5-mm left upper quadrant; 5-mm right iliac fossa (selectively). 2. Ileocolic pedicle defined…
High and Low Ligation of the Inferior Mesenteric Artery KEY STEPS Insertion of ports and position of patient as detailed in the respective chapter for each procedure. Laparoscopic assessment and…
Port Placement, Laparoscopic Specimen Extraction Site, and Port Site Closure KEY POINTS Operating ports should be inserted lateral to the inferior epigastric vessels, paying attention to keep the tract of…
Equipment, Operating Room Setup, and Patient Positioning KEY POINTS Monitor placement for viewing by entire operating room team. Access to supply of CO2. Electric bed with stirrups. Access to electrocautery…
