Colon, Rectum, and Appendix



Fig. 4.1
Instrument table





Instruments and Cables





  • 30° 5 mm laparoscope


  • Cold light source cable


  • CO2 pipe and filter


  • Monopolar electrocautery


  • Patient return electrode (REM)


  • Sterile instrument bag


  • Monopolar and bipolar electrocautery cables


Laparoscopic Instrument Table (Fig. 4.1)





  • Sutures: 0 absorbable braided suture, skin wound closure sutures


  • Surgical scalpel blade No. 23


  • Gauzes


  • Stainless surgical bowl


  • Gross-Maier dressing forceps


  • 2 Bernhard towel forceps


  • Veress needle and 10 mL syringe


  • 1 10 mm trocars


  • 2 5 mm trocars


  • Needle holder


  • 2 Backhaus forceps


  • 2 Farabeuf retractors


  • Metzenbaum scissors


  • Mayo scissors


  • 2 tissue forceps with teeth


  • Anatomical thumb forceps


  • 2 Kocher forceps


  • 2 Klemmer forceps


  • 2 endoloop (2-0 absorbable braided)


  • Bipolar laparoscopic forceps


  • Laparoscopic scissors


  • 2 Johann forceps without ratchet handle


  • Thermos



4.2 Right Colectomy


The bed is placed in standard position with shoulder holders. The patient lies supine with left arm along the body. Laparoscopic rack is placed on the right side (Fig. 4.2).

A334519_1_En_4_Fig2a_HTML.gifA334519_1_En_4_Fig2b_HTML.gif


Fig. 4.2
(a–c) Equipe and patient position during appendectomy and right colectomy

Specific surgical drapes are used.

Laparotomic Instrument Table Must Be Always Ready for Use.



A334519_1_En_4_Figa_HTML.gif


Surgical Steps



1.

Landmark recognition

 

2.

Colic vessel isolation and section

 

3.

Transverse colon mobilization and isolation

 

4.

Ileus mobilization and isolation

 

5.

Intracorporeal ileocolic anastomosis

 

6.

Specimen extraction with Pfannenstiel incision

 


Instruments and Cables





  • 30° 5/10 mm laparoscope


  • Cold light source cable


  • CO2 pipe and filter


  • Monopolar electrocautery


  • Patient return electrode (REM)


  • 2 sterile instrument bags


  • Bipolar laparotomic forceps


  • Monopolar and bipolar electrocautery cables


  • Ultrasonic dissector/radio-frequency cables


  • Irrigation/suction laparoscopic device


  • Bladder catheterization set


A334519_1_En_4_Fig3_HTML.gif


Fig. 4.3
(a, b) Instrument table


Laparoscopic Instrument Table (Fig. 4.3 a, b)



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Jun 5, 2017 | Posted by in GASTROENTEROLOGY | Comments Off on Colon, Rectum, and Appendix

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