Marking of the planned stoma, which should be placed in the outer third of the rectus muscle on the line between the spine and the navel.
Midline laparotomy. Insertion of a ring drape and a self-retaining retractor.
Thorough exploration of the entire abdomen and exclusion of extrahepatic metastases.
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Laparotomy and Exploration
Soundsettings -
Mobilization of the Sigmoid Colon
Soundsettings The colon is pulled medially and the lateral adhesions with the peritoneum lateral to the abdominal wall are sharply dissected.
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Central Transection of the Inferior Mesenteric Artery
![Central Transection of the Inferior Mesenteric Artery]()
Soundsettings Pre-aortic dissection after opening the retroperitoneum and central transection of the inferior mesenteric artery under ligatures (central piercing) while preserving the superior hypogastric plexus.
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Resection of the Descending Colon
![Resection of the Descending Colon]()
Soundsettings Mobilization of the descending-sigmoid junction. Transection of the mesosigmoid up to the centrally ligated artery. Resection of the oral margin with a GIA stapler.
Total Mesorectal Excision; Visualization of the Left Ureter
Incision of the pelvic floor peritoneum with the electric knife. Excision and detachment of the mes
Incision of the pelvic floor peritoneum with the electric knife. Excision and detachment of the mes
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