Video summary: Left hemicolectomy
March 26, 2008 § Leave a comment
This is a summary of a video I’ve made of a left hemicolectomy. The video is published on www.oncolex.org.
Left hemicolectomy
- Preoperative MRI shows a tumor in the descending colon, infiltrating the left abdominal wall and two parts of the small intestine.
- View from the head end of the operating table.
- Tumor area and infiltration in the small intestine.
- View from the foot end of the operating table.
- One segment of small intestine cut on both sides of infiltration using GIA stapler. Same procedure applied to the other segment:
- Creating an opening in the mesentery for the stapler.
- Inserting GIA stapler and cutting intestine on both sides of the tumor infiltration.
- Cutting and ligating blood vessels in the mesentery.
- Restoring intestinal continuity:
- Making opening in intestine on both sides of removed segments.
- Creating side-to-side anastomosis using GIA stapler.
- Suturing openings in two layers.
- Dividing the transverse colon using GIA stapler.
- Dividing the sigmoid colon using GIA stapler.
- Cutting and ligating blood supply to the colon segment.
- Identifying the left ureter (double in this patient), and dissecting it up to the kidney.
- Dissecting the tumor from the left abdominal wall.
- A biopsy from the Gerota’s fascia of the left kidney is sent for frozen section, showing no malignancies.
- Operation specimen:
- Colon and small intestine segments.
- Tumor area.
- Posterior resection edge.
- Restoring colonic continuity:
- Making opening in colon on both sides of removed segments.
- Creating side-to-side anastomosis using GIA stapler.
- Suturing openings in two layers.
- Overview of abdomen:
- Left ureter.
- Left kidney.
- Pancreas.
- Applying electrocautery to the Gerota’s fascia of the left kidney to stop bleeding and destroy any superficial cancer cells.
- Irrigating the abdomen with sterile water and placing a drain
- Closing the wound.
The Sterile Eye 
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