Left hemicolectomy, open, curative

  1. Laparotomy

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    Median skin incision with left circumcision of the navel. Transection of subcutaneous fat tissue and fascia with diathermy.

  2. Determination of the oral resection margin

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    Determination of the oral resection margin
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    The proximal resection margin depends on the location and size of the tumor. After identifying the middle colic artery, loop the transverse colon slightly distal to it. In the present case, the middle colic artery is not centrally resected due to the advanced age and the distant location of the tumor.

  3. Mobilization of the descending colon and sigmoid colon

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    Mobilization of the descending colon and sigmoid colon
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    The small intestine is held laterally to the right; the descending colon and sigmoid colon are released from the lateral adhesions. In doing so, at the level of the tumor, the plane of dissection must be led out of the peritoneal fold, as the tumor appears to be penetrating the serosa.

  4. Entering the omental bursa

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    Opening of the omental bursa by detaching the greater omentum from the transverse colon to the left of the planned resection site. Transection of the splenocolic ligament with clamps for mobilization of the left flexure.

Detachment of the greater omentum from the stomach

Detachment of the greater omentum from the stomach including the gastroepiploic arcade.Note: Includ

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general and visceral surgery

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