Hemicolectomy left, open, curative - general and visceral surgery
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Laparotomy
Exploration
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
Entering the omental bursa
Open the lesser peritoneal sac by dividing the greater omentum off the transverse colon to the left of the planned margin of resection. In order to mobilize the splenic flexure, divide the splenocolic ligament between clamps.
Note: The omental bursa may also be opened by dividing the gastrocolic ligament superior to the colon to the left of the proximal resection margin.
Dividing the greater omentum off the stomach
Transecting the greater omentum
Freeing the splenic flexure
Dividing the left colic vein
Dividing the left colic artery
Dividing the mesocolon
Transecting the colon
Anastomosing the colon
Drainage and wound closure
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