Hybrid-NOTES - Sigmoid Resection

  1. Creation of Pneumoperitoneum / Placement of Working Trocars

    Video
    Creation of Pneumoperitoneum / Placement of Working Trocars
    Soundsettings

    Creation of pneumoperitoneum by puncturing the abdominal cavity subcostally on the left with the Veress needle.

    Placement of the first trocar (5mm) with a blunt obturator approximately 3 cm cranial to the navel. After an orienting inspection of the abdominal cavity, three additional 5mm trocars are introduced under vision (5mm optics) in the left-lateral mid-abdomen and in the right mid-abdomen. Finally, the fourth trocar is placed suprapubically.

    Tip:

    Before each incision, the skin is infiltrated with a local anesthetic.

Preparation on the Gerota's fascia from medial and transection of the inferior mesenteric vein

Careful incision of the peritoneum medial to the inferior mesenteric vein and layer-wise, mostly bl

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general and visceral surgery

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