Video summary: Left hemicolectomy

March 26, 2008 § Leave a comment

Left hemicolectomy

This is a summary of a video I’ve made of a left hemicolectomy. The video is published on www.oncolex.org.

Watch the hemicolectomy video

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.

Watch the hemicolectomy video

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