Hemicolectomy left, open, curative - general and visceral surgery

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  • Laparotomy

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    Laparotomy
     

    Median laparotomy with the incision passing the umbilicus on the left. Transect the subcutaneous tissue and fascia with diathermy.

  • Exploration

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    Exploration
     

    Insert a circular wound edge protector followed by a retractor. Assess tumor size and location. The tumor is palpable just inferior to the splenic flexure. Explore the abdomen to rule out metastases.

  • Determining the proximal resection margin

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    Determining the proximal resection margin
     

    The upstream resection margin depends on the size and location of the tumor. After identifying the medial colic artery encircle the transverse colon slightly downstream of the artery. Because of the advanced age and distant tumor in the present case, this structure will not be included in the resection.

  • Mobilizing the descending colon and sigmoid

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    Mobilizing the descending colon and sigmoid
     
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  • Entering the omental bursa

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  • Dividing the greater omentum off the stomach

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  • Transecting the greater omentum

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  • Freeing the splenic flexure

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  • Dividing the left colic vein

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  • Dividing the left colic artery

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  • Dividing the mesocolon

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  • Transecting the colon

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  • Anastomosing the colon

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  • Drainage and wound closure

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  1. Laparotomy
  2. Exploration
  3. Determining the proximal resection margin
  4. Mobilizing the descending colon and sigmoid
  5. Entering the omental bursa
  6. Dividing the greater omentum off the stomach
  7. Transecting the greater omentum
  8. Freeing the splenic flexure
  9. Dividing the left colic vein
  10. Dividing the left colic artery
  11. Dividing the mesocolon
  12. Transecting the colon
  13. Anastomosing the colon
  14. Drainage and wound closure
date of publication: 06.02.2012

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